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THE MOTHER AND HER CHILD 



THE SADLER CLASSICS 



THE MOTHER AND HER CHILD. Things 
that all mothers, fathers, and everyone who has 
to do with the care of the child should know. 
Illustrated. 12mo $1.50 

WORRY AND NERVOUSNESS; or, The 
Science of Self-Mastery. Illustrated. 12 mo. 
Si. 50 

THE PHYSIOLOGY OF FAITH AND FEAR; 
or, The Mind in Health and Disease. Illus- 
trated. Fourth edition. 12mo. . Si. 50 

THE CAUSE AND CURE OF COLDS. Illus- 
trated. Third edition. 12mo. . . Sl.OO 

THE SCIENCE OF LIVING; or, The Art of 
Keeping Well. With many drawings. 12mo. 
Si. 50 



A. C. McCLURG & CO. 

CHICAGO 



THE MOTHER 
AND HER CHILD 



BY 

WILLIAM S. SADLER, M. D. 

PROFESSOR OF THERAPEUTICS, THE POST-GRADUATE MEDICAL 
SCHOOL OF CHICAGO; DIRECTOR OF THE CHICAGO INSTITUTE 
OF PHYSIOLOGIC THERAPEUTICS; FELLOW OF THE 
AMERICAN MEDICAL ASSOCIATION; MEMBER OF 
THE CHICAGO MEDICAL SOCIETY; THE ILLI- 
NOIS STATE MEDICAL SOCIETY; THE 
AMERICAN ASSOCIATION FOR THE AD- 
VANCEMENT OF SCIENCE, ETC. 



LENA K. SADLER, M. D. 

ASSOCIATE DIRECTOR OF THE CHICAGO INSTITUTE OF PHYSI- 
OLOGIC therapeutics; fellow of the American medical 
association; member of the Chicago medical 
society; the medical women's club of Chi- 
cago; NATIONAL CONGRESS OF MOTHERS AND 
PARENT -TEACHER ASSOCIATION; THE 
CHICAGO WOMAN'S CLUB, ETC. 



ILLUSTRATED 




CHICAGO 
A. C. McCLURG & CO, 

1916 



^\1 



Copyright 

A. C. McClurg & Co. 

1916 



Published August, 1916 



Copyrighted in Great Britain 



(& 



SEP -i 1916 



W. F. HALL PRINTING COMPANY, CHICAGO 



)d.A437502 



TO 

"BILLY" 
WHO, BECAUSE OF HIS UNCONSCIOUS CONTRIBUTIONS TO ITS 
PRACTICAL FEATURES, SHOULD BE REGARDED AS A 
CO-AUTHOR, THIS VOLUME IS AFFECTION- 
ATELY DEDICATED BY HIS PARENTS 
THE AUTHORS 



PREFACE 

FOR many years the call for a book on the mother and her 
child has come to us from patients, from the public, and 
now from our publishers — and this volume represents our 
efforts to supply this demand. 

The larger part of the work was originally written by Dr. Lena 
K. Sadler, with certain chapters by Dr. William S. Sadler, but 
in the revision and re-arrangement of the manuscript so much 
work was done by each on the contributions of the other, that 
it was deemed best to bring the book out under joint author- 
ship. 

The book is divided into three principal parts : Part i, deal- 
ing with the experience of pregnancy from the beginning of 
expectancy to the convalescence, of labor ; Part n, dealing with 
the infant from its first day of life up to the weaning time ; Part 
in, taking up the problems of the nursery from the weaning to 
the important period of adolescence. 

The advice given in this work is that which we have tried 
out by experience — both as parents and physicians — and we 
pass it on to mothers, fathers, and nurses with the belief 
that it will be of help in their efforts at practical and scientific 
" child culture." We believe, also, that the expectant mother 
will be aided and encouraged in bearing the burdens which are 
common to motherhood by the advice and instruction offered. 

While we have drawn from our own professional and per- 
sonal experience in the preparation of this book, we have also 
drawn freely from the present-day literature dealing with the 
subjects treated, and desire to acknowledge our indebtedness 
to the various writers and authorities. 

vii 



viii PREFACE 

We now jointly send forth the volume on its mission, as a 
contribution toward lightening the task and inspiring the efforts 
of those mothers, nurses, and others who honor us by a pe- 
rusal of its pages. 

William S. Sadler. 
Lena K. Sadler. 
Chicago, 191 6. 



CONTENTS 



CHAPTER 

I 

II 

III 

IV 

V 

VI 

VII 

VIII 

IX 

X 

XI 



XII 

XIII 

XIV 

XV 

XVI 

XVII 

XVIII 

XIX 

XX 

XXI 

XXII 



PART I 

THE MOTHER 

PAGE 

The Expectant Mother I 

Story of the Unborn Child 7 

Birthmarks and Prenatal Influence ... 14 

The Hygiene of Pregnancy 21 

Complications of Pregnancy 35 

Toxemia and Its Symptoms 47 

Preparations for the Natal Day .... 53 

The Day of Labor 63 

Twilight Sleep and Painless Labor ... 71 

Sunrise Slumber and Nitrous Oxid ... 84 

The Convalescing Mother 93 

PART II 

THE BABY 

Baby's Early Days 103 

The Nursery 114 

Why Babies Cry 123 

The Nursing Mother and Her Babe . . . 133 

The Bottle-Fed Baby . 147 

Milk Sanitation 156 

Home Modification of Milk 165 

The Feeding Problem 177 

Baby's Bath and Toilet 190 

Baby's Clothing 202 

Fresh Air, Outings, and Sleep .... 213 
ix 



CONTENTS 



CHAPTER PAGE 

XXIII Baby Hygiene 222 

XXIV Growth and Development 232 

PART III 

THE CHILD 

XXV • The Sick Child 251 

XXVI Baby's Sick Room 266 

XXVII Digestive Disorders 274 

XXVIII Contagious Diseases 285 

XXIX Respiratory Diseases 300 

XXX The Nervous Child 308 

XXXI Nervous Diseases . 323 

XXXII Skin Troubles 333 

XXXIII Deformities and Chronic Disorders ... 341 

XXXIV Accidents and Emergencies 348 

XXXV Diet and Nutrition 360 

XXXVI Caretakers and Governesses 370 

XXXVII The Power of Positive Suggestions ... 380 

XXXVIII Play and Recreation 390 

XXXIX The Puny Child 400 

XL Teaching Truth 405 

Appendix . 427 

Index 449 



ILLUSTRATIONS 



The mother and her child Frontispiece ^ 

FIGURE PAGE 

i Steps in early development . . . . . . . 10 

2 The " expectant " costume 23 

3 The photophore 43^ 

4 Taking the blood pressure 48 '^ 

5 Breast binder 59 s / 

6 How to hold the baby no 

7 Making the sleeping blanket 117 

8 In the sleeping blanket 118 

9 Homemade ice box 149 

10 Heating the bottle 151 

n A sanitary dairy 158 

12 Articles needed for baby's feeding 167 

13 Supporting the baby for the bath 194 

14 Developmental changes 240 

15 The cooling enema 290 

16 X ray showing tuberculosis of the lung .... 346 

17 Father and Mother Corn and Morning Glory . . 406 



XI 



PART I 
THE MOTHER 



THE MOTHER AND 
HER CHILD 



PART I 
THE MOTHER 



CHAPTER I 
THE EXPECTANT MOTHER 

THERE can be no grander, more noble, or higher calling 
for a healthy, sound-minded woman than to become the 
mother of children. She may be the colaborer of the business 
man, the overworked housewife of the tiller of the soil, the 
colleague of the professional man, or the wife of the leisure 
man of wealth; nevertheless, in every normal woman in every 
station of life there lurks the conscious or sub-conscious ma- 
ternal instinct. Sooner or later the mother-soul yearns and 
cries out for the touch of baby fingers, and for that maternal 
joy that comes to a woman when she clasps to her breast the 
precious form of her own babe. 

MOTHERHOOD THE HIGHEST CALLING 

Motherhood is by far woman's highest and noblest profession. 
Science, art, and careers dwindle into insignificance when we 
attempt to compare them with motherhood. And to attain 
this high profession, to reach this manifest " goal of destiny," 
women are seeking everywhere to obtain the best information, 
and the highest instruction regarding " mothercraft," " baby- 
hood," and " child culture." 



2 THE MOTHER AND HER CHILD 

In an Indiana town not long ago, at the close of a lecture, 
a small, intellectual-appearing mother came forward, and, ten- 
derly placing her tiny and emaciated infant in my arms, said: 
"O Doctor! can you help me feed my helpless babe? I'm 
sure it i.s going to die. Nothing seems to help it. My father 
is the banker in this town. I graduated from high school and 
he sent me to Ann Arbor, and there I toiled untiringly for four 
years and obtained my degree of B. A. I have gone as far as 
I could — spent thousands of dollars of my unselfish father's 
money — but I find myself totally ignorant of my own child's 
necessities. I cannot even provide her food. O Doctor ! can't 
something be done for young women to prepare them for 
motherhood? " 

MOTHERCRAFT PREPARATION 

The time will come when our high and normal schools will 
provide adequate courses for the preparation of the young 
woman for her highest profession, motherhood. This young 
mother, who had reached the goal of Bachelor of Arts, found 
to her sorrow that she was entirely deficient in her education 
and training regarding the duties and responsibilities of a 
mother. In every school of the higher branches of education 
that train young women in their late teens there should be a 
chair of mothercraft, providing practical lectures on baby 
hygiene, dress, bathing, and the general care of infants, and 
giving instruction in the rudiments of simple bottle-feeding, 
together with the caloric values of milk, gruels, and other 
ingredients which enter into the preparation of a baby's food. 

Young women would most enthusiastically enroll for such 
classes, and as years passed and marriage came and children 
to the home, imagine the gratitude that would flood the souls 
of the young mothers who were fortunate enough to have 
attended schools where the chairs of motherhood prepared 
them for these new duties and responsibilities. 

EARLY MEDICAL SUPERVISION 

Just as soon as it is known that a baby is coming into the 
home, the expectant mother should engage the best doctor 



THE EXPECTANT MOTHER 3 

she can afford. She should make frequent calls at his office 
and intelligently carry out the instruction concerning water 
drinking, exercise, diet, etc. Twenty-four hour specimens of 
urine should be frequently saved and taken to the physician 
for examination. In these days the blood-pressure is closely 
observed, together with approaching headaches and other evi- 
dences of possible kidney complications. The early recognition 
of these dangers is accompanied by the immediate employment 
of appropriate sweating procedures and other measures designed 
to promote the elimination of body poisons. Thus science is 
able effectively to stay the progress of the high blood-pressure 
of former days, and which was so often followed by eclampsia 
■ — uremic poisoning. 

In these days of careful urine analysis, expertly administered 
anaesthetics, and up-to-date hospital confinements, the average 
intelligent woman may enter into pregnancy quite free from 
the oldtime fears, whose only rewards were grief and cankering 
care. All fear of childbirth and all dread of maternal duties 
and sacrifices do not in the least lessen the necessary unpleas- 
antness associated with normal labor. It lies in the choice of 
every expectant mother to journey through the months of 
pregnancy with dissatisfaction and resentment or with joy 
and serenity. " The child will be born and laid in your arms 
to be fed, cared for, and reared, whether you weep or smile 
through the months of waiting." 

THE RESENTFUL MOTHER 

A little woman came into our office the day of this writing, 
saying: " Doctor, I'm just as mad as I can be; I don't want to 
be pregnant, I just hate the idea." As I smiled upon this 
girl-wife of nineteen, I drew from my desk a sheet of paper 
and slowly wrote down these words for the head of a column : 
" Got a mad on," and for the head of another, " Got a glad on ; " 
and then we quickly set to work carefully to tabulate all the 
results that having a " mad on " would bring. We found to 
her dismay that its harvest would be sadness of the heart, 
husband unhappy, work unbearable, while all church duties 
as well as social functions would be sadly marred. Then, just 



4 THE MOTHER AND HER CHILD 

as carefully, we tabulated the benefits that would follow having 
a " glad on." Her face broke into a smile ; she laughed, and as 
she left the office she assured me that she would accept Na- 
ture's decree, make the best of her lot, and thus wisely align 
herself with the normal life demands of old Mother Nature. 
This view of her experience, she came to see, would bring the 
greatest amount of happiness to both herself and husband. 
She left me, declaring that she was just "wild for a baby;" 
and there is still echoing in my ears her parting words : " I*m 
leaving you, Oh, such a happy girl ! and I'm going home to 
Harold a happy and contented expectant mother." 

There often enters on the exit of a discontented and resentful 
expectant mother, a woman, very much alone in the world — 
perhaps a bachelor maid or a barren wife, who, as she sits 
in the office, bitterly weeps and wails over her state of loneliness 
or sterility; and so we are led to realize that discontentment 
is the lot of many women; and we are sometimes led to regret 
that ours is not the power to take from her that hath and give 
to her that hath not. 

EARLY SIGNS OF PREGNANCY 

Among the first questions an expectant mother asks is: 
"What are early signs of pregnancy?" The answer briefly is: 

1. Cessation of menstruation. 

2. Changes in the breast. 

3. Morning sickness. 

4. Disturbances in urination. 

Menstruation may be interrupted by other causes than preg- 
nancy, but the missing of the second or third periods usually 
indicates pregnancy. Accompanying the cessation of menstrua- 
tion, changes in the breast occur. Sensation in the breasts 
akin to those which usually accompany menstruation are mani- 
fested at this time in connection with the unusual sensations 
of stinging, prickling, etc. Fully one-half of our patients do 
not suffer with " morning sickness ; " however, it is the general 
consensus of opinion that " morning sickness " is one of the 



THE EXPECTANT MOTHER 5 

early signs of pregnancy, and these attacks consist of all 
gradations — from slight dizziness to the most severe vomiting. 
It is an unpleasant experience, but in passing through it we 
may be glad in the thought that " it too, will pass." 

Because of the pressure exerted by the growing uterus upon 
the bladder, disturbances in urination often appear, but as the 
uterus continues *to grow and lifts itself up and away from the 
bladder these symptoms disappear. 

Chief of the later signs of pregnancy are " quickening " or 
fetal movements. The movements are very much like the 
" fluttering of a young birdling." They usually are felt by the 
expectant mother between the seventeenth and eighteenth 
weeks. This sign, together with the noting of the fetal heart- 
beat at the seventh month, constitute the positive signs of 
pregnancy. 

PROBABLE DATE OF DELIVERY 

And now our expectant mother desires to know when to 
expect the little stranger. From countless observations of 
childbirth under all conditions and in many countries, the preg- 
nant period is found to cover about thirty-nine weeks, or two 
hundred and seventy-three days. There are a number of ways 
or methods of computing this time. Many physicians count 
back three months and add seven days to the first day of the 
last menstruation. For instance, if the last menstruation were 
December 2 to 6, then, to find the probable day of delivery, we 
count back three months to September 2, and then add seven 
days. This gives us September 9, as the probable date of 
delivery. The real date of delivery may come any time within 
the week of which this calculated date is the center. 

As a rule, ten days to two weeks preceding the day of delivery, 
the uterus " settles " down into the pelvis, the waist line becomes 
more comfortable, and the breathing is much easier. 

On the accompanying page, may be found a table for com- 
puting the probable day of labor, prepared in accordance with 
the plan just described. 



THE MOTHER AND HER CHILD 



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CHAPTER II 
STORY OF THE UNBORN CHILD 

TO every physician in every community, sooner or later in 
his experience there come thoughtless women making 
requests that we even hesitate to write about. Their excuses 
for the crime which they seek to have the physician join them 
in committing, range all the way from " I don't want to go 
to the trouble," to " Doctor, I've got seven children now, and 
I can't even educate and dress them properly ; " or, maybe, " I 
nearly lost my life with the last one." 

EMBRYOLOGICAL IGNORANCE 

One little woman came to us the other day from the suburbs, 
and honestly, frankly related this story: 

"We've been married just six months, I have continued my 
stenographic work to add the sixty-five dollars to our monthly 
income. Doctor, we must meet our monthly payments on the 
home, I must continue to work, or we shall utterly fail. I am 
perfectly willing a baby shall come to us two years from now, 
but, doctor, I just can't allow this one to go on, you must help 
me just this once. Why doctor, there can't be much form or 
life there, it's only three months now, or will be next week, and 
you know it's nothing but a mass of jelly." 

She had talked with a " confidential friend " in her neighbor- 
hood, had been told that she " could do it herself," but fearing 
trouhle or infection, had come to the conclusion she had better 
go to a " clean, reputable physician," to have the abortion 
performed. 

This is not the place to narrate the experiences of the unfor- 
tunate victims of habitual criminal abortion, but we would like 
to impress upon the reader some realization of the untimely 

7 



8 THE MOTHER AND HER CHILD 

deaths, the awful suffering, and the life-long remorse and 
sorrow of the poor, misguided women who listen to the criminal 
advice of neighborhood " busybodies." The infections, the 
invalidism, the sterility that so often follow in the wake of 
these practices, are well known to all medical people. 

THE STREAM OF LIFE 

And so after the patient's last statement, " It's nothing but 
a mass of jelly," we began the simple but wonderfully beautiful 
story of the development of the " child enmothered." Just as 
all vegetables, fruits, nuts, flowers, and grains come from seeds 
sown into fertile soil, and just as these seeds receive nourish- 
ment from the soil, rain, and sunshine, so all our world of 
brothers and sisters, of fathers and mothers, came from tiny 
human seeds, and in their turn received nourishment from the 
peculiarly adapted stream of life, which flows in the maternal 
veins for the nourishment and upbuilding of the unborn embryo. 

Every little girl and boy baby that comes into the world, has 
stored within its body, in a wonderfully organized capsule, a 
part of the ancestral stream of life that unceasingly has 
flowed down through the centuries from father to son and 
from mother to daughter. This " germ plasm " is a divine gift 
to be held in trust and carefully guarded from the odium of 
taint, to be handed down to the sons and daughters of the 
next generation. Any young man who grasps the thought that 
he possesses a portion of the stream of life, that he holds it 
in sacred trust for posterity, cannot fail to be impressed with 
a sense of solemn responsibility so to order his life as to be 
able to transmit this biologic trust to succeeding generations 
free from taint and disease. 

THE PROCESS OF FERTILIZATION 

Just as within the body of "Mother Morning Glory" (See 
Fig. 15) may be found the ovary or seed bed, so there are two 
wonderfully organized bodies about the size of large almonds 
found in the lower part of the female abdomen on either side of 
the uterus, and connected to it by two sensitive tubes. There 
ripens in one of these bodies each month a human baby-seed, 



STORY OF THE UNBORN CHILD 9 

which finds its way to the uterus through the little fallopian tube 
and is apparently lost in the debris of cells and mucus which, with 
the accompanying hemorrhage go to make up the menstrual flow. 
This continues from puberty to menopause, each gland alter- 
natingly ripening its ovum, only to lose it in the periodical 
phenomenon of menstruation, which is seldom interrupted save 
by that still more wonderful phenomenon of conception. 

At the time of conception, countless numbers of male germ- 
cells (sperms) are lost — only one out of the multitude of these 
perfectly formed sperms made up of the mosaics of heredi- 
tary depressors, determiners, and suppressors that so subtly 
dictate and determine the characteristics and qualifications of 
the on-coming individual — I repeat, only one of these won- 
derful sperms finds the waiting ovum (Fig. 1). In this search 
for the ovum, the sperm propels itself forward by means of its 
tail — for the male sperm in general appearance very much 
resembles the little pollywog of the rain barrel (Fig. 1). 

The fateful meeting of the sperm and the ovum takes place 
usually in the upper end of one of the fallopian tubes. It is 
a wonderful occasion. The wide-awake, vibrating lifelike 
sperm plunges head first and bodily into the ovum. The tail, 
which has propelled this bundle of life through the many wan- 
derings of its long and perilous journey, now no longer needed, 
drops off and is lost and forgotten. This union of the male 
and female sex cells is called " fertilization." There immediately 
follows the most complete blending of the two germ cells — 
one from the! father and one from the mother — each with 
its peculiar individual, family, racial, and national character- 
istics. Here the combined determiners determine the color of 
the eyes, the characteristics of the hair, the texture of the 
skin, its color, the size of the body, the stability of the nervous 
system, the size of the brain, etc., while the suppressors do a 
similar work in the modification of this or that family or racial 
characteristic. 

THE FIRST WEEKS OF LIFE 

The fertilized ovum remains in the tube for about one week, 
when it slowly makes its way down into the uterus, all the 



10 



THE MOTHER AND HER CHILD 




Sperm and Ovum 




Cell Division 




Fetus at Six Weeks 




Fetus at Three Months 



Fig. i. Steps in Early Development 



STORY OF THE UNBORN CHILD n 

while rapidly undergoing segmentation or division. It does not 
grow much in size during this first week, but divides and 
subdivides first, into two parts, then four, then eight, then 
sixteen and so on, until we have a peculiar little body made 
up of many equally divided parts, and known as the " Mul- 
berry Mass" (Fig. i). The blending of the sperm and ovum 
has been perfect, the division of the original body multitu- 
dinous. 

While this division of the united sex cells is progressing, 
a wonderful change is also taking place in the inside lining 
of the uterus. Instead of the usual thin lining, it has greatly 
thickened and has become highly sensitized, and as the ovum 
enters the uterus from the fallopian tube, this sensitized lining 
catches it and holds it in its folds — actually covers it with 
itself — holding the precious mass much as the cocoon, you have 
so often seen fastened to the side of a plant or leaf, holds its 
treasure of life. 

Just as soon as the new uterine home is found the baby 
heart begins to make its appearance, as also do many other 
rudimentary parts. By the end of the third week, our round 
mass has flattened and curved and elongated, and the nervous 
system and brain begin to develop, while the primitive ears 
begin to appear. At this time, the alimentary canal presents 
itself as one straight tube which is a trifle larger at the head 
end. And it is interesting to note that at this early date, even 
the arms and legs are beginning to bud and push out from the 
body. 

LATER EMBRYONIC DEVELOPMENT 

In the fourth and fifth weeks, the lungs and the pancreas 
may be found, the heart develops, the nervous system has taken 
on more definite form, and several of the larger blood-vessels 
are appearing. 

By the eighth week, by the most wonderful and complicated 
processes of overlapping, pushing out, indentation, enfolding, 
budding, pressing, and curving, the majority of the important 
structures are formed — the eyes, ears, nose, hands, feet, ab- 
dominal organs, and numerous glands. Thus, at the end of 



12 THE MOTHER AND HER CHILD 

two months, almost every structure and organ necessary to 
life is present in a rudimentary state. 

AT THE END OF THREE MONTHS 

By the close of the third month, witness the work of creation ! 
From the blending of the two germ cells there has come forth 
a beautifully formed body (Fig. i). True, it is but three and 
one half inches in length, but it is nevertheless a perfect body. 
About this time, the sex may be determined. The eyes, nose, 
ears, chin, arms and legs and even the fingers and toes may all 
be clearly distinguished. 

A "jelly mass" at three months? No, by no means! No! 
Life and form and features are all there. It really has a 
face, whose features may easily be delineated. 

In all my experience, I have yet to find the woman who 
wished to continue in her wicked and criminal intent after she 
had listened to this story of the creative development of the 
first three months of her " child enmothered." 

During the next four months, which take us to the close of 
the seventh, rapid growth and farther development take place 
to the extent, that, should birth occur at that time, life may 
continue under proper conditions. 

LAST WEEKS OF PREGNANCY 

Everything is now nearing completion — only awaiting fur- 
ther growth, development, and strength — except some of the 
bone development, which takes place during the remaining two 
months. Growth is rapid, strength is doubled, and as the two 
hundred and seventy-three days draw to a close, everything 
has been completed. It has all taken place according to the 
laws of creation in an infinite way and with clock-like precision. 

With the developmental growth of the product of conception, 
the uterus or room that had been particularly prepared for the 
" big reception " of the second week, has also grown to great 
dimensions. It fills almost the entire abdomen and as a result 
of the pressure against the diaphragm the breathing is some- 
what embarrassed. 

The door of this " room " has been closed by a special 



STORY OF THE UNBORN CHILD 13 

mechanism, while, in the fullness of time, Mother Nature begins 
the delicate work of opening the door, through whose portals 
passes out into the world the completed babe. 

The authors feel that this discussion of, and protest against, 
abortions, should be accompanied by an appropriate consider- 
ation of the control of pregnancy. We are never going to 
eliminate the abortion curse of present-day civilization by merely 
preaching against it — warnings and denouncements alone will 
not suffice to remove the stain. Notwithstanding our feelings 
and convictions in this respect, we are also well aware of the 
fact that public sentiment is not now sufficiently ripe to wel- 
come such a full and frank discussion of the subject of the 
prevention of conception as the authors would feel called upon 
to present; we are equally cognizant of the fact that existing 
postal regulations and other Federal laws are of such a char- 
acter (at least capable of such interpretation) as possibly to 
render even the scientific and dignified consideration of such, 
subjects entirely out of question. 



CHAPTER III 
BIRTHMARKS AND PRENATAL INFLUENCE 

IN the preceding chapter we learned that when the two 
germ cells came together, there occurred a complete blending 
of two separate and distinct hereditary lines, reaching from 
the present away back into the dim and distant past. By the 
union of these two ancestral strains a new personality is 
formed, a new individual is created, with its own peculiar 
characteristics. 

HEREDITARY TRAITS 

Probably none of the laboriously acquired accomplishments 
of the present generation can be directly — and as such — 
handed down to our children. What we are to be and what 
we will do in this world was largely determined by the laws 
of heredity by the time we were well started on our develop- 
ment experience en-utero during the third or fourth week of 
our prenatal existence, as outlined in a former chapter. 

It is now generally accepted in scientific circles that acquired 
characteristics are not transmissible. Someone has aptly stated 
this truth by saying that " wooden heads are inherited, but 
wooden legs are not." This does not by any means imply that 
we do not have power and ability to fashion our careers and 
carve out our own destiny, within the possible bounds of our 
hereditary endowment and environmental surroundings. He- 
redity does determine our " capital stock," but our own efforts 
and acts determine the interest and increase which we may 
derive from our natural endowment. From the moment concep- 
tion takes place — the very instant when the two sex cells meet 
and blend — then and there " the gates of heredity are forever 
closed." From that time on we are dealing with the problems 

14 



BIRTHMARKS AND PRENATAL INFLUENCE 15 

of nutrition, development, education, and environment; there- 
fore, so-called prenatal influence can have nothing whatever 
to do with heredity. 

A father may have acquired great talent as a physician or 
a surgeon, in fact he may hold the chair of surgery in a medical 
college, but each of his children come into the world without 
the slightest knowledge of the subject, and, as far as direct and 
immediate heredity is concerned, will have to work just about 
as hard to master the subject as will the same average class of 
children whose parents were not surgeons. This must not be, 
taken to mean that certain abilities and tendencies are not 
inheritable — for they are ; but they are inherited through 
the parents — and not from them — directly. These transmitted 
charactertistics are largely " stock " traits, and usually have long 
been present in the " ancestral strain." 

MATERNAL IMPRESSIONS 

A mother may sing and pray all through the nine months 
of expectancy, or she may weep and scold, or even curse. In 
neither case can she influence the spiritual or moral tendencies 
of her child and cause it, through supposed prenatal influence, 
to be born with criminal tendencies or to grow up a pious 
lad or become a devout minister. These tendencies and char- 
acteristics are all largely determined by the " depressors," 
" suppressors," and " determiners " which were present in the 
two microscopic and mosaic germ cells which united to start 
the embryo at the time of conception. 

The child is destined to be born, endowed, and equipped with 
the mental, nervous, and physical powers which his line has 
fallen heir to all through the past ages. Down through the 
ages education, religion, environment, and other special in- 
fluences have no doubt played a small part in influencing and 
determining hereditary characteristics; just as environment in 
the ages past changed the foot of the evolving horse from 
a flat, " cushiony " foot with many toes (much needed in the 
soft bog of his earlier existence) into the " hoof foot " of 
later days, when harder soil and necessity for greater fleetness, 
assisted by some sort of " selection " and " survival," con- 



16 THE MOTHER AND HER CHILD 

spired to give us the foot of our modern horse, and this story 
is all plainly and serially told in the fossil and other remains 
found in our own hemisphere. It would appear that many, many 
generations of education and environment are required to in- 
fluence markedly the established and settled train of heredity 
regarding any particular element or characteristic in any par- 
ticular line or lines of hereditary tendencies. 

EUGENIC SUPERSTITION 

There is probably more misinformation in the minds of the 
people on the subject of "maternal impressions" and "birth- 
marks" than any other scientific or medical subject. The 
popular belief that, if a pregnant woman should see an ugly 
sight or pass through some terrifying experience, in some 
mysterious way her unborn child would be " marked," deformed, 
or in some way show some blemish at birth, is a time-honored 
and ancient belief. 

Such unscientific and unwarranted teaching has been handed 
down from mother to daughter through the ages, while the 
poor, misguided souls of expectant women have suffered untold 
remorse, heaped blame upon themselves, lived lives literally 
cursed with fear and dread — veritable slaves to superstition 
and bondage — all because of the simple fact that a certain per- 
centage of all children born in this world have sustained some 
sort of an injury or " embryological accident " during the first 
days of fetal existence. For instance, take the common birth- 
mark of a patch of reddened skin on the face, brow, or neck. 
As soon as the baby is born, the worried mother asks in 
anxious tones : " Doctor, is it all right, is it perfect, has it 
got any birthmarks ? " On being told that the baby has a 
round, red patch on its left brow, the ever-ready statement 
of the mother comes forth : " Yes, I knew I'd mark it, I was 
picking berries one day about three months ago, and I ate and 
ate, until I suddenly remembered I might mark my baby, and 
before I knew what I was doing, I touched my brow and I 
just knew I had marked my baby." Do you know, reader, that 
that birthmark was present fully four months before she passed 
through that experience in the berry patch ? And yet so worried 



BIRTHMARKS AND PRENATAL INFLUENCE 17 

and apprehensive has been the pregnant mother, that, although 
she can never successfully predict the " birthmarks " and blem- 
ishes of her child, nevertheless when these defects are disclosed 
at birth she is unfailingly able immediately to recall some 
extraordinary experience which she has carefully stored away 
in her memory and which, to her mind, most fully explains 
and accounts for the defect. 

Is it much wonder that in the very early days of embryonic 
existence, during the hours of delicate cell division, indentation, 
outpushing, elongation, and sliding of young cells — is it much 
wonder, I repeat — that there occur a few malformations, 
blemishes, or other accidents which persist as " birthmarks ? " 

CAUSES OF BIRTHMARKS 

There are many factors which may enter into the production 
of birth-blemishes, deformities, monstrosities, etc. These in- 
fluences are all governed by certain definite laws of cause and 
effect. A pre-existent systemic disease in the father, or a co- 
existent disorder in the mother, may be a leading factor. A 
mechanical injury, such as a sudden fall, a blow, or a kick, 
or certain kinds of prolonged pressure, not to mention restric- 
tions and contractions of the maternal bony structures, may 
all possibly contribute something to these prenatal miscarriages 
of growth and development. Maternal or prenatal embryonic 
infections could bring about many sorts of birthmarks and 
malformations. These defects might also be caused by certain 
types of severe inflammatory disorders in the uterus during 
the early days of pregnancy. 

The same factors that produce the accidents of embryology 
resulting in malformations or monstrosities in the human family, 
are also operative in the case of our lesser brethren of the 
animal kingdom, for monstrosities and birth-defects are very 
common among the lower animals, notwithstanding the fact 
that the animal mother probably does not " believe in birth- 
marks." 

" It is a striking fact that during the nineteenth century, 
the teratologists, those who have scientifically investigated the 
causes of monstrosities and fetal morbid states, have almost 



18 THE MOTHER AND HER CHILD 

without exception, rejected the theory of maternal impres- 
sions." Scientists and physicians are coming to recognize the 
fact that fears and frights do not in any way act as causes in 
the production of monstrosities and deformities. Let us seek 
forever to liberate all womankind from the common and harass- 
ing fear and the definite dread and worry that, because they 
failed to control themselves at the instant of some terrifying 
sight or experience, they were directly responsible for the mis- 
fortune of their abnormal offspring. 

It should be remembered that there exists no direct connec- 
tion whatsoever between the nervous system of the unborn 
child and the nervous system of the mother. The only phys- 
iological or embryological relationship is of a nutritional order, 
and even that is indirect and remote. 

ROLE OF THE PLACENTA 

By the end of the third month, the " cocoon " attachment 
described in chapter two has disappeared; the fetus is slowly 
pushed away from the uterus which has so snugly held it for 
more than eleven weeks; while upon the exact site of its pre- 
vious attachment the thickened uterine membrane undergoes a 
very interesting and important change — definite blood vessels 
begin to form — which begin indirectly to form contact with 
the maternal vessels, and thus it is that the placenta, or " after 
birth" is formed; and then, by means of the umbilical cord, 
nourishment from the mother's blood-stream is carried to the 
growing and rapidly developing child. In exchange for the 
nourishing stream of life-giving fluid by which growth and 
development take place, the embryo gives off its poisonous ex- 
cretions which are carried back to the placenta, from which 
they are absorbed into the veinous circulation of the mother; 
so, while the mother does, through the process of nutrition, 
influence growth and development in the embryo, she is wholly 
unable to produce specific changes and such definite develop- 
mental errors as birthmarks and other deformities. 

Just as truly as it would be impossible so to frighten a setting 
hen as to " mark " or otherwise influence the form or char- 
acter of the chicks which would ultimately come forth from 



BIRTHMARKS AND PRENATAL INFLUENCE 19 

the eggs in her nest, it is just as truly impossible to frighten 
the pregnant mother and thereby influence the final develop- 
mental product of the human egg which is so securely tucked 
away in its uterine nest; for, when conception has occurred, 
the human embryo is just as truly an egg — fashioned and 
formed — as is the larger and shell-contained embryo of the 
chick which lies in the nest of the setting hen. 

And so we are compelled to recognize the fact that there 
is little more danger to the unborn child when the mother is 
frightened than when the father is scared. The one con- 
tributes as much as the other to the general character of the 
child, while neither is to blame for development errors and 
defects. 

SUGGESTION AND HEREDITY 

Certain fears are suggested to children. For twenty years 
I lived under the delusion that I was terribly afraid of snakes 
— more so than any other human being ; for I was told when 
a mere child that I had been " marked with the fear of snakes," 
that just two months before I saw the peep of day, my esteemed 
mother had been terrified by a snake. Everywhere I went, I 
announced to sympathizing and ofttimes mischievous friends, 
that " I was marked with the fear of snakes and must never be 
frightened with them." It is needless to add in passing, that 
I -was teased and frightened all through my girlhood days. 
I was a veritable slave to the bondage of snake-fear. Every- 
where I went I looked for my dreaded foe, expecting to sit 
on one, step on one, or to have one drop into my lap from the 
roof. 

The day of deliverance came after marriage, when in a 
supreme effort to deliver me from the shackles of fear, the 
goodman of the house tenderly, but firmly, maneuvered a morn- 
ing walk so that it halted in front of a large plate-glass window 
of the Snake Drug Store in San Francisco. Just back of this 
plate glass, and within eighteen inches of my very nose, were 
fifty-seven varieties of the reptiles, big and small, streaked and 
checkered, quiet and active. After much remonstrance and 
waiting, I came-to — gazed at the markings, beautiful in their 



20 THE MOTHER AND HER CHILD 

exactness — while slowly the change of mind took place. Faith 
took the place of fear, calmness subdued panic, and I was 
wondrously delivered from the veritable bondage of a score 
of years. And so it is that the mother suffers and then the 
child suffers, ofttimes a living death, because of the super- 
stition " I'm marked," while there is ever present the fear or 
dread that " something is going to happen, because I'm different 
from all other individuals — because ' I'm marked ! ' " 



CHAPTER IV 
THE HYGIENE OF PREGNANCY 

AS soon as a woman discovers that she is pregnant, she 
should sit down and quietly think out the plan for the 
nine months of expectancy. 

The cessation of the menses may come as a surprise to her, 
and for a while she is more or less confused; she must go 
over the whole situation and adjust future plans to fit in with 
this new and all important fact. From a large experience with 
maternity cases, I have reached the conclusion that the larger 
percentage of pregnancies do come as a surprise, and in many 
instances a complete change of program must be painstakingly 
thought out. This is especially true of the business woman, 
the professional woman, the busy club woman, or the active 
society woman. 

EARLY PLANNING 

Let me say to the woman who is pregnant for the first time, 
the experiences of the pregnant state should cause you no fear, 
worry, or anxiety. Giving birth to a baby is a perfectly natural, 
normal procedure, and if you are in reasonable health — if 
your physician tells you you are a fairly normal woman — then 
you can dismiss further thought of danger and go on your way 
rejoicing. For thousands of years maternity has been women's 
exclusive profession and no doubt will continue to be many ages 
hence. 

By far the most important and the first thing to do is care- 
fully to select the best physician your means will allow, and 
place yourself under his or her care. Your doctor will help 
you to plan wisely and intelligently during the waiting time, 
for physicians have learned from experience that the better 

21 



22 THE MOTHER AND HER CHILD 

care the pregnant woman receives, the easier will be her labor, 
and the more speedy and uneventful the recovery. 

And now, we proceed to take up one by one the particular 
phases of the hygiene of pregnancy which touch the comfort, 
convenience, and health of both the mother and her unborn 
child. 

THE CLOTHING 

At all times and under all circumstances the pregnant woman's 
clothing should be comfortable, suitable for the occasion, ar- 
tistic, and practical. And to be thus beautifully clothed is to 
be as inconspicuous as is possible. Of all times, occasions, and 
conditions, that of pregnancy demands modesty in color, sim- 
plicity in style, together with long straight lines (Fig. 2). For 
the " going out " dress, select soft shades of brown, blue, wine, 
or dark green. Let the house dresses be simple, easy to launder, 
without constricting waist bands, of the one-piece type, in every 
way suitable for the work at hand. Under this outer dress, a 
princess petticoat should cover a specially designed maternity 
corset (if any corset at all be worn), to which is attached 
side hose-supporters. A support for the breasts may be worn 
if desired, it should be loose enough to allow perfect freedom 
in breathing. 

The union suit may be of linen, silk, or cotton, with the weight 
suitable for the season. Stockings and shoes should be of a 
comfortable type, straight last, low or medium heel and at 
least as wide as the foot. There are two or three shoes on 
the market that are particularly good, whose arches are flexible, 
heels comfortable, straight last, and whose soles look very much 
like the lines of the foot unclothed. This style is particularly 
good during the maternity days. Painful feet are a great 
strain upon the general nervous system. Who of us has not 
seen women with strained, tense faces hobbling about in high- 
heeled, narrow-toed shoes? And if we followed them we would 
not only see tenseness and strain in the features of the face, 
but could hear outbursts of temper on the least provocation. 
Aching feet produce general irritability. If ease of body and 
calmness of spirit is desired, wear shoes that are comfortable, 



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Fig. 2. The " Expectant " Costume 



The long lines, so admirable for maternity wear are portrayed in this handsome afternoon 
costume. Tunic waist is made with shoulder yoke from which fullness hangs in tine 'plait- 
ing, with panel at back, front and under arms. The set-in vest is of black -striped gold cloth. 
trimmed with gold thread crochet buttons and with tiny waistcoat of black moire. Sleeves 
are of Georgette crepe. Loose adjustable girdle of black moire ribbon. Full skirt is attached 
on elastic to china silk underbodice. Material: Crepe de chine or any other soft, clinging 
fabric. 



24 THE MOTHER AND HER CHILD 

and the surprising part of it is that many of them are very good 
looking. 

Toward the end of pregnancy ofttimes the feet swell, in 
which instance larger shoes should be worn in connection with 
the bandaging of the ankles and legs. 

During the latter days of expectancy an abdominal supporter 
may be worn advantageously. Much of the backache and heavi- 
ness in the pelvis is entirely relieved by the supporting of the 
pendulous abdomen with a well-fitted binder. An ordinary piece 
of linen crash may be fitted properly by the taking in of darts 
at the lower front edge; or elastic linen, or silk binder may be 
secured ; in fact, any binder that properly supports the abdomen 
will answer the purpose. 

It should be within the means of every pregnant woman to 
have a neat, artistic out-door costume, for social, club and 
church occasions (Fig. 2). For no reason but illness should 
an expectant mother shut herself up in doors. 

True men and true women hold the very highest esteem for 
the maternal state, and the opinion of all others matters not; 
so joyfully go forth to the club, social event, concert, or church ; 
and to do this, you must have a well-designed, artistic dress. 
The material does not matter much, but the shade and style are 
important. 

DIET 

There are certain laws which govern the diet at all times; 
for instance, the man who digs ditches requires more of a 
certain element of food and more food in general, than does 
the man who digs thoughts out of his brain. The growing 
child requires somewhat different elements of food than does 
an adult. In other words, " The diet should suit the times, 
occasions, occupations, etc." 

In the case of the expectant mother it should be remembered 
that the child gains nine-tenths of its weight after the fifth 
month of pregnancy, and it is, therefore, not necessary that 
a woman shall begin " eating for two " until after the fifth 
month. And since it is also true that the baby doubles its 
weight during the last eight weeks of pregnancy, it follows that 



THE HYGIENE OF PREGNANCY 25 

then is the time when special attention must be given to the 
quantity as well as the quality of " mothers' food." 

During the first five months, if the urine and blood-pressure 
are normal, the " lady in waiting " should follow her usual 
dietetic tastes and fancies so long as they do not distress or 
cause indigestion. Because of the additional work of the 
elimination of the fetal wastes, much water, seven or eight 
glasses a day, should be taken ; while one of the meals — 
should there be three — may well consist largely of fruit. All 
of the vegetables may be enjoyed; salads with simple dressings 
and fruits may be eaten liberally. Of the breads, bran, whole 
wheat, or graham are far better for the bowels than the finer 
grain breads, or the hot breads. 

Something fresh — raw — should be taken every day, such as 
lettuce, radishes, cabbage salad, and fresh fruits. 

If the prospective mother is accustomed to the liberal use of 
meat, providing the blood-pressure and urine are normal, she 
may be able to indulge in meat once a day. Many physicians 
believe that the maternal woman should eat meat rather spar- 
ingly — from once a day to once or twice or three times a 
week. 

Of the desserts, gelatine, junket, ice cream, sponge cake, and 
fruit are far better than the rich pastries, which never fail even 
in health to encourage indigestion and heart burn. The fruit- 
ades are all good. Candies and other sweets may be eaten in 
moderation. Alcohol should be avoided. Tea and coffee should 
be restricted, and in many cases abandoned. For many, two 
meals and a lunch of fruit or broth are better than three full 
meals. There is a continual and increased accumulation of 
waste matter which must be thrown off by the lungs, kidneys, 
bowels, and skin ; so that clogging of one channel of elimination 
makes more work for one or more of the other eliminative 
organs. 

Sometimes the craving for food is excessive, and the desire 
to nibble between meals is quite troublesome. These unusual 
feelings should be controlled or ignored. A glass of orangeade 
will sometimes satisfy this unnatural craving. Save your appe- 
tite for meal time — for a good appetite means good digestion 



26 THE MOTHER AND HER CHILD 

— all things equal. The woman who habitually eats between 
meals is the sluggish, constipated individual who needs to acquire 
self-control and learn self-mastery. 

WATER DRINKING 

Water is the circulating medium of the body, from which the 
digestive secretions are formed, and by which the food is 
assimilated and distributed to individual cells. And, finally, 
water is the agent for dissolving and removing waste products 
from the body through the various eliminating organs. We 
literally live, think, and have our being, as it were, under water. 
The tiny cell creatures of our bodies, from the humble bile 
workers of the liver to the exalted thinking cells of the brain, 
all carry on their work submerged. Accordingly, the amount 
of water we drink each day, determines whether the liquids 
circulating through our tissues shall be pure, fresh, and life- 
giving, or stagnant, stale, and death-dealing. 

Thirst is the expression of the nervous system, constituting 
a call for water, the same as hunger represents a call for food. 
Pure water, free from all foreign substances, is the best liquid 
with which to quench this thirst. 

It is just as important to supply abundance of water for 
the proper bathing and cleansing of the internal parts of the 
body, as it is to wash and bathe the external skin frequently. 
The living tissues are just as literally soiled and dirtied by their 
life action and their poisonous excretions, as is the skin soiled 
by its excretions of sweat and poisonous solids. Thus the 
regular drinking of water is absolutely necessary to enable the 
body to enjoy its internal bath, and this internal cleansing is 
just as grateful and refreshing to the cells and tissues, as is the 
external bath to the nerves which exist in the skin. 

The total amount of water necessary varies according to the 
nature of one's work, the amount of sweating from the skin, 
the moisture of the atmosphere, the amount of water in the 
food, etc. We believe the average person requires about eight 
glasses of liquid a day; that is, about two quarts. By the 
word " glass " we refer to the ordinary glass or goblet, two 
of which equal one pint. This amount of water should be 



THE HYGIENE OF PREGNANCY 27 

increased, if anything, throughout pregnancy; while, during 
the later months, the amount of water taken each day should 
be at least doubled. 

In the condemnation of so-called artificial beverages, an 
exception should be made of the fruit juices. The fresh, 
unfermented juices of various fruits come very near being 
pure, distilled water, as they consist of only a little fruit sugar 
and acid, together with small amounts of flavoring and coloring 
substances, dissolved in pure water. None of these substances 
contained in pure fruit juice needs to be digested. 

Lemonade not too sweet, and taken in moderate quantities, 
is certainly a beverage free from objection when used by the 
average pregnant woman. Unripe or overripe fruits frequently 
cause bowel disturbances; as also do the millions of germs 
which lurk upon the outside of fruits, and which find their 
way into the stomach and bowels when these fruits are eaten 
raw without washing or paring. Otherwise, the juices of fruits 
and melons are wholesome food beverages when consumed in 
moderation. 

EXERCISE 

It should be the regular practice of every expectant mother 
to spend a portion of each day in agreeable, suitable exercise or 
physical work of some description. This exercise will be far 
more beneficial if it can be taken in the open air. The weather 
and the strength of the patient must be taken into consideration 
and the necessary modifications of the daily exercise should be 
made. 

An expectant mother living in the city and enjoying the 
average health and strength, should engage in such agreeable 
exercise as the raising of flowers, the training of vines, with 
brisk walks in the fresh air. As much time as possible should 
be spent in the parks. 

The rural " mother in waiting," may do light gardening, rais- 
ing of chickens, or pigeons, training of vines, or other outdoor 
work she may enjoy. 

No matter what kind of weather prevails, a daily brisk walk- 
should be taken, out of doors, on the porch or in a room with 



2& THE MOTHER AND HER CHILD 

open windows. A daily sweat, as well as the daily prayer, is 
good for the well-being of the expectant mother. All forms 
of light housework are commendable. Keep out of crowds. 
Spend more time in the parks than in the department stores. 
An occasional evening at the concert or theater is diversion 
and harmless provided the ventilation is good. Such exercises 
as horseback riding, bicycling, dancing, driving over rough 
roads, lifting and straining of any kind, and all other forms of 
fatiguing exercise should be avoided. 

REST 

Rest and relaxation are quite necessary for men and women 
even in the best of health. A kind providence has arranged 
that we spend a large portion of our time resting, and sleeping. 
In addition to unbroken rest at night it is well for the pros- 
pective mother quietly to withdraw from the family circle, 
when the first signs of fatigue begin to appear, and indulge in 
a little rest, before she gets into a state of nervousness — where 
nerves twitch and she becomes irritable. 

A mother who has borne six children, who has had little domestic 
help, and who yet retains her youthful appearance and energy, thinks 
her present condition due to the fact that while carrying and nursing 
her babies she never permitted herself to reach that stage of exhaus- 
tion where her nerves twitched, her voice shrilled, and she became 
irritable. She made it a practice to drop her work when these 
symptoms began to appear, and to seek the sanctuary of a quiet room 
apart from her family, if only for ten or fifteen minutes. And, 
most important, from the very start she trained her household to 
respect her right thus to draw apart. 

I have told many women whose household duties press 
hard : " Your husband would rather see a cold lunch on the 
table, or ' go out ' for dinner, while his wife rested, smiling 
and happy, than to have a most sumptuous meal spread before 
him and the wife tired, and fretful." Every woman should 
make it the rule of her life to stop just this side of the outburst 
of words, and lie down long enough, breathing deeply, to calm 
the spirit. 



THE HYGIENE OF PREGNANCY 29 

FRESH AIR 

" With all persons plenty of fresh air, night and day, is 
indispensable to health, and to none more than the pregnant 
woman. She should sleep with the windows open, or out of 
doors, at all seasons of the year; of course, making due allow- 
ance for the severity of the winters in the North. It is not 
only necessary to provide for the adequate ventilation of 
sleeping-rooms, but also for that of the living-rooms of the 
house- 
Many persons, who are quite particular to open wide the 
windows of the bedrooms, forget that the other rooms need it 
quite as much. All the rooms of the house which are occupied 
should be thoroughly ventilated by throwing doors and windows 
open every morning; at night when the family is assembled the 
air must be changed now and then or it will become unfit for 
human lungs." 

Men and women are outdoor animals. They were made to 
live in a garden, not a house. Remember that each person 
requires one cubic foot of fresh air every second. Don't allow 
the temperature of living-rooms, during the winter season, to 
go above sixty-eight degrees. If your home has no system of 
ventilation, open wide the windows and doors several times a 
day and enjoy the blessings of a thorough-going flushing with 
fresh air. 

Oxygen is the vital fire of life. Our food, however well 
digested and assimilated, is just as useless to the body without 
oxygen, as coal is to the furnace without air. It is equally 
important to keep up the proper degree of moisture in the air 
of the living-rooms. 

BATHING 

Bathing is made necessary by the clothes we wear and by 
our indoor life. If the skin were daily exposed to sunshine and 
fresh air, it would seldom be necessary to bathe. The neglect 
of regular bathing results in overworking the liver and kidneys, 
and debilitates the skin. Regular bathing — ofttimes sweating 
baths — is very essential to the hygiene of pregnancy. 



3 o THE MOTHER AND HER CHILD 

The neutral bath (97 F.) is excellent to quiet the nerves 
and induce sleep. Morning bathing is an exceedingly valuable 
practice. If properly taken before breakfast or midway between 
breakfast and lunch, it is found to be refreshing and tonic in 
nature. The feet should be in warm water, the application of 
cold should be short and vigorous. A rough mit dipped in cold 
water, rubbed over the body until the skin is pink, is a splendid 
tonic. 

Warm cleansing baths should be taken twice a week at night. 
There is no good reason for the use of the vaginal douche 
during pregnancy. 

THE TEETH 

Because the mother's system is drained of the lime salts 
which aid in building up the bones of the child, along with 
other metabolic changes which cause the retention of certain 
acids which ofttimes affect the teeth, they should be frequently 
examined and carefully guarded. Severe dental work should 
be avoided, but all cavities should receive temporary fillings' 
while the teeth are kept free from deposits. 

As a preventive to this tendency of the teeth to decay, a 
simple mouth wash of one of the following may be used after 
meals : 

1. One teaspoon of milk magnesia. 

2. One tablespoon of lime water. 

3. One-half teaspoon common baking soda. 
Any one to be dissolved in a glass of water. 

DIRECTIONS FOR SAVING URINE SPECIMENS 

Beginning with the second voiding of urine after rising on 
the morning of the day you are to save the specimen, save all 
that is passed during the following twenty-four hours, including 
the first voiding on the second morning. Measure carefully the 
total quantity passed in the twenty-four hours. Shake thor- 
oughly so that all the sediment will be mixed, and immediately 
after shaking take out eight ounces or thereabouts for delivery 
to the physician the same forenoon. The following items 



THE HYGIENE OF PREGNANCY 31 

should be noted, and this memoranda should accompany the 
specimen : 

1. Patient's name. 

2. Address. 

3. This specimen was taken from a twenty-four hour void- 
ing of urine, which began at .... a. m , and ended at 

.... a. m 

4. The total quantity voided during this twenty-four hours 
Was .... pints. 

This specimen should reach the laboratory by ten o'clock 
the same morning. 

It is of utmost importance the specimen should be taken to 
your physician every two weeks, and oftener if conditions 
indicate it. Take it yourself at the appointed time. 

THE BOWELS 

Owing to the increasing pressure exerted upon the intestines, 
most expectant mothers experience a tendency to sluggish 
bowels and constipation. This unpleasant symptom is usually 
increased during the later months. 

In the first place, a definite time must be selected for bowel 
action. It may ofttimes be necessary, and it is far less harmful, 
to insert a glycerine suppository into the rectum, than to get 
into the enema habit. The injection of a large quantity of 
water into the lower bowel will mechanically empty it; but the 
effects are atonic and depressing as regards future action. 

Before we take up the advisability of taking laxatives let us 
consider what foods will aid in combating constipation. The 
following list of foods are laxative in their action and will 
be found helpful in overcoming the constipation so often associ- 
ated with pregnancy: 

1. All forms of sugar, especially fruit sugar, honey, syrup, 
and malt. All the concentrated fruit juices. Sweet fruits, such 
as figs, raisins, prunes, fruit jellies, etc. 

2. All sour fruits, and fruit acids: Apples, grapes, goose- 
berries, grape fruit, currants, plums, and tomatoes. 

3. Fruit juices, especially from sour fruits: Grape juice, 
lemonade, fruit soup, etc. 



32 THE MOTHER AND HER CHILD 

4. All foods high in fat: Butter, cream, eggs, eggnog, ripe 
olives, olive oil, nuts — especially pecans, brazil nuts, and pine 
nuts. 

5. Buttermilk and koumiss. 

6. All foods rich in cellulose: Wheat flakes, asparagus, 
cauliflower, spinach, sweet potatoes, green corn and popcorn, 
graham flour, oatmeal foods, whole-wheat preparations, bran 
bread, apples, blackberries, cherries, cranberries, melons, 
oranges, peaches, pineapples, plums, whortleberries, raw cab- 
bage, celery, greens, lettuce, onions, parsnips, turnips, lima 
beans, and peanuts. 

White bread should be tabooed, and in its place a well-made 
bran bread should be used. Two recipes for bran bread follow, 
one sweetened and containing fruit, the other unsweetened: 

BRAN BREAD RECIPES 

1. Two eggs, beaten separately; three-fourths cup of molasses, 
plus one round teaspoon of soda; one cup of sour cream; one cup 
of sultana seedless raisins; one cup of wheat flour, plus one 
heaping teaspoon baking powder; two cups of bran; stir well 
and bake one hour. 

2. One cup of cooking molasses; one teaspoon of soda; one 
small teaspoon of salt, one pint of sour milk or buttermilk, 
one quart of bran, one pint of flour. Stir well, and bake for 
one hour in a very slow oven. It may be baked in loaf, or 
in gem pans, as preferred. The bread should be moist and 
tender, and may be eaten freely, day after day, and is quite 
sure to have a salutary effect if used persistently. 

The drinking of one-half glass of cold water on rising in 
the morning often aids in keeping the bowels active. Of the 
laxative drugs which may be used at such a time, cascara 
sagrada and senna are among the least harmful. Two recipes 
of senna preparation follow, and may be tried in obstinate cases : 

1. Senna Prunes. Place an ounce of senna leaves in a jar 
and pour over them a quart of boiling water. After allowing 
them to stand for two hours strain, and to the clear liquid add a 
pound of well-washed prunes. Let them soak over night. In 
the morning cook until tender in the same water, sweetening 



THE HYGIENE OF PREGNANCY 33 

with two tablespoons of brown sugar. Both the fruit and 
the sirup are laxative. Begin by eating a half-dozen of the 
prunes with sirup at night, and increase or decrease the amount 
as may be needed. 

2. Senna with prunes and figs. This recipe does not call 
for cooking. Take a pound of dried figs and a pound of dried 
prunes, wash well. Remove the stones from the prunes and if 
very dry soak for an hour. Then put both fruits through the 
meat chopper, adding two ounces of finely powdered senna 
leaves. Stir into this mixture two tablespoons of molasses to 
bind it together, the result being a thick paste. Begin by eating 
at bedtime an amount equal to the size of an egg, and increase 
or decrease as may be necessary. Keep the paste tightly cov- 
ered in a glass jar in a cool place. If the senna is distasteful 
a smaller quantity may be used at first. 

CARE OF THE BREASTS 

The breasts are usually neglected during the months of 
pregnancy, and as a result complications occur after the baby 
comes which cause no end of discomfort to the mother. If, 
during the pregnancy, the breasts are washed daily with liquid 
soap and cold water, and rubbed increasingly until all sensitive- 
ness has disappeared, they may be toughened to the extent that 
no pain whatsoever is experienced by the mother when the babe 
begins to nurse. During the last month of pregnancy a solution 
of tannin upon a piece of cotton may be applied after the usual 
vigorous bathing. If the nipples are retracted they should be 
massaged until visible results are attained. 

THE MENTAL STATE 

Keep the mind occupied with normal, useful, and healthy 
thoughts. Listen to no tales of woe. Stay away from the 
neighborhood auntie dolefuls. Keep yourself happy and free 
from all worry, care, and anxiety. 

" Put no faith in fables of cravings, markings, signs, or 
superstitions. They are all unfounded vagaries of ignorant 
old women and will not bear investigation." 

Don't take drugs for worry and sleeplessness. Take a bath. 



34 THE MOTHER AND HER CHILD 

The secret of deliverance from worrying is self-control. 
Minimize your difficulties. Cultivate faith and trust. 

The conditions which favor sound sleep are: Quiet, mental 
peace, pure blood, good digestion, fresh air (the colder the 
better), physical weariness (but not fatigue), mental weari- 
ness (but not worry). 

When tempted to borrow trouble, when harassed by fictitious 
worries, remember the old man who had passed through many 
troubles, most of which never happened. Train the mind to 
think positive thoughts. Replace worry-thought with an oppo- 
site thought which will occupy the mind and enthuse the soul. 
Drive out fear-thought by exercising faith-thought. Cultivate 
the art of living with yourself as you are, and with the world 
as it is. Learn the art of living easily. Associate with children 
and learn how to forget the vexing trifles of everyday life. 

There is something decidedly wrong with one's nerves when 
everybody is constantly " getting on them." They are either 
highly diseased or abnormally sensitive. Every woman is a 
slave to every other that annoys her. 

Fear is capable of so disarranging the circulation as to con- 
tribute to the elevation of blood-pressure — which will be more 
fully considered in a later chapter. 



CHAPTER V 
COMPLICATIONS OF PREGNANCY 

IT is the purpose of this chapter to take up the various com- 
plications which may appear in the course of an otherwise 
normal pregnancy, and offer advice appropriate for their 
management. 

MORNING SICKNESS 

About one-half of the expectant mothers that come under 
our care and observation, experience varying degrees of nausea 
or " morning sickness." This troublesome symptom makes its 
appearance usually about the fourth week of pregnancy and 
lasts from six to eight weeks. 

On attempting to rise from the bed, there is an uncomfortably 
warm feeling in the stomach followed by a welling up into the 
throat of a warmish, brackish tasting liquid which causes the 
patient to hasten to rid herself of it; or, as she rides on the 
train, on the street cars, in a carriage or automobile, she fre- 
quently senses the same unpleasant and nauseating symptoms 
during the second and third months of pregnancy. Normally, 
this uncomfortable symptom quite disappears by the end of the 
third month. A number of remedies have been suggested for 
it, but that which seems to help one, gives little or no relief to 
another; we therefore mention a variety of remedies which 
may be tried. 

First and most important of all remedies — is to keep the 
bowels open. Sluggishness of the intestinal tract greatly 
increases the tendency to dizziness and nausea. During the 
attack, it is advisable not to attempt to brush the teeth, gargle, 
or even drink cold water. While you are yet lying down, the 
maid or the goodman of the house should bring to you a piece 

35 



36 THE MOTHER AND HER CHILD 

of dry, buttered toast, a lettuce sandwich with a bit of lemon 
juice, or perhaps a cup of hot milk or hot malted milk. Coffee 
helps to raise the blood-pressure, and all articles of diet that 
tend to raise the blood-pressure are best avoided during preg- 
nancy. A cup of cocoa may be tried, but, as a rule, women at 
this time do not relish anything sweet. Oftentimes a salted 
pretzel is just the thing, or a salted wafer will greatly help. 
Remain in bed from one-half to one hour and then rise very 
slowly. There should be plenty of fresh air in the room, as 
remaining in overheated places is quite likely to produce a feel- 
ing of sickness at the stomach. 

When the attack comes on during a train ride, open the 
window and breathe deeply, this, with the aid of a clove or the 
tasting of a bit of lemon, will usually give relief. In extreme 
instances the patient should lie down flatly on the back, with 
the eyelids closed. Go to the rear of the street car, so that you 
can get off quickly if necessity demands ; breathe deeply of the 
air; resort to the use of cloves or lemons; and thus by many 
and varied methods will the expectant mother be enabled to con- 
tinue her journey or finish her shopping errand. We would 
suggest that, as far as possible, walking should be substituted 
for riding. I have never heard of a woman being troubled with 
nausea while walking in the parks, on shady streets, along the 
country road, or on the beach. 

Of the medicines prescribed for " morning sickness " and the 
nausea of pregnancy, cerium oxalate taken three times a day in 
doses of five grains each, is probably one of the best. 

The persistent or pernicious vomiting which continues on 
through pregnancy will be spoken of later. 

HEARTBURN 

Acid eructations are spoken of as " heartburn," and are 
occasioned by the increased activity of the acid making glands 
of the stomach. Under certain conditions this acid content 
of the stomach is regurgitated back into the throat and even 
belched up into the mouth. In this condition it is well to avoid 
most acid fruits. Ice cream and other frozen desserts are 
beneficial. The lowered temperature of cold foods depresses 



COMPLICATIONS OF PREGNANCY 37 

the activity of the acid glands, as also does the fats of the 
cream, while protein food substances such as white of egg, 
cheese, and lean meat, help by combining with the excess of 
acid present in the stomach. Buttermilk or the prepared lactic 
acid milk, if taken very cold, is often helpful, notwithstanding 
it is an acid substance, in connection with the dietetic manage- 
ment of heartburn. If the acid eructations be troublesome 
between the meals, the taking of calcined magnesia (one round 
teaspoon in a glass of cold water), or, one-half teaspoon of 
common baking soda in a glass of water, will afford immediate 
and temporary relief. Simply nibbling a little from a block of 
magnesia will often give instant relief. These alkalines effect- 
ively neutralize the mischievous acids which cause the so-called 
" heartburn." 

IRRITABILITY OF THE BLADDER 

The flexing or bending forward of the gravid uterus, by mak- 
ing pressure on the bladder, sets up more or less irritation and 
consequent disturbance of the urinary function. The capacity 
of the bladder is actually diminished, and this produces frequent 
urination. There is usually no pain connected with this annoy- 
ing symptom — the chief discomfort is the frequent getting up 
at night. This inconvenience may be lessened by drinking less 
water after six p. m. These bladder disturbances are most 
marked in the earlier months, and gradually disappear as the 
uterus raises higher up into the abdomen ; although this symptom 
may reappear in the last two weeks, as the head descends down- 
ward on its outward journey. 

Should the urine at any time become highly colored, take a 
specimen to your physician at once. Twenty-four hour speci- 
mens of urine should be taken by the patient to her physician 
every two weeks. Do not send it — take it. 

LEUCORRHEA 

While leucorrhea is an unusual complication of pregnancy. 
it is often very troublesome and sometimes irritating. Do not 
take a vaginal douche unless it has been ordered by your phy- 
sician, and even then make sure that the force of the flow of 



38 THE MOTHER AND HER CHILD 

water is very gentle. The bag of the fountain syringe should 
be hung only about one foot above the hips. Soap and water 
used externally, followed by vaseline or zinc ointment, will 
usually relieve the accompanying irritation. 

THREATENED ABORTION 

In the third chapter attention was called to the formation of 
the placenta or " after birth," on the site of the attachment of 
the cocoon embryo. At this particular time of the pushing away 
of the embryo from the uterine wall, one of the accidents of 
pregnancy occurs, in which the embryo becomes completely 
detached and starts to escape from the uterus, accompanied by 
varying degrees of pain and hemorrhage. The symptoms of 
this threatened abortion are: 

i. Heavy menstrual pains. 

2. Backache. 

3. Hemorrhage. 

The approach of the calendar date of the third month of 
pregnancy should be watched for, and all work of a strenuous 
nature studiously avoided; while at the first signs of the back- 
ache or any unusual symptom, the expectant mother should 
immediately go to bed and send for the physician. One patient 
who had aborted on four different occasions was able to pass 
this danger period by adhering to a rigid program of pre- 
vention during her fifth pregnancy. Two weeks before the 
third month arrived she discontinued her teaching and went 
to bed. She remained there four weeks, thus running over into 
the middle of the following month. Gradually, she resumed her 
duties of teaching, carried her precious bundle of life to full 
term, and is now the proud and happy mother of a splendid 
baby girl. 

Should abortion seem imminent, from one-eighth to one- 
fourth of a grain of morphine sulphate will greatly reduce all 
uterine contractions, and this, with the general quieting effect 
on the whole system, will usually suffice to prevent an abortion. 
The patient should quietly remain in bed from three days to one 
week. 



COMPLICATIONS OF PREGNANCY 39 

If the abortion takes place — if a clot accompanied by hemor- 
rhage is passed — save everything, lie in bed very quietly and 
send for your physician at once ; and when he does arrive, be 
content if he does not make an internal examination at once, 
for if he should there is more or less danger of infection. And 
I repeat — throw nothing away — burn nothing up, save every- 
thing that passes until your physician has carefully examined it. 

SUDDEN ABDOMINAL PAIN 

Sudden or severe pains in the abdomen should be reported at 
once to your physician, while you should immediately go to bed 
and quietly remain there until you receive further instruction 
from your doctor when he calls. 

In the later stages of pregnancy any appearance of blood 
should likewise be noted and reported without delay. These 
symptoms may not always be serious, but they are also associ- 
ated with grave complications, and should, therefore, be given 
prompt attention. 

MISCARRIAGE 

Abortion is a term used to designate the loss of the embryo 
prior to or at the third month. Miscarriage applies to the 
expulsion of the fetus or emptying of the uterus after the 
third month. It is possible for a miscarriage to occur anytime 
during the interim between the fourth and ninth months. After 
the uneventful passing of the third month, if an accident threat- 
ens, we instruct the mother to remain quietly in bed three to 
five days at the calendar date comparable with each menstrual 
period; and as she approaches the seventh month, we adjure 
her to be unusually careful and prudent. 

The causes of miscarriages are many : Disease of the embryo, 
imperfect fetal development, some constitutional disease of the 
mother, a faulty position of the uterus, or it may result from 
something unusual about the lining of the uterus such as an 
endometritis — an inflammation of the mucus membrane. 

Expectant mothers who manifest symptoms of a threatened 
miscarriage should studiously avoid such exercises as climbing, 
riding, skating, tennis, golf, dancing, rough carriage or auto- 



4 o THE MOTHER AND HER CHILD 

mobile riding, and such taxing labor as sweeping, lifting, wash- 
ing, running the sewing machine, window cleaning, the hanging 
of pictures, draperies, etc. 

CRAVINGS 

Within reason, a pregnant mother should follow her natural 
appetite and satisfy her dietetic longings. Should she desire 
unusual articles of food, as far as possible she should have 
them. The idea has long prevailed that if the mother does not 
get what her longing soul supremely desires, that the on-coming 
baby is going to cry and cry until it is given what the mother 
wanted with all her heart and did not get. Such an idea is the 
very quintessence of folly and the personification of foolishness 
and superstition. 

Many a precious babe has suffered as a victim of this notion 
of " craving " and " marking." One mother gave her baby a 
huge mouthful of under-ripe banana because " she knew that 
was just what he wanted, because, when pregnant, she had 
craved and craved bananas and for some reason or another she 
did not get them." The soft, smooth piece of banana slipped 
down the baby's throat — on into the stomach and intestines — 
caused intestinal obstruction and finally the end came; and we 
registered one more victim to the fallacies of fear and the 
superstitious belief in " cravings " and " markings." Occasion- 
ally some cravings are unusual and freakish, for instance, egg 
shells, leather, candles, chalk, and other abnormal tastes are 
developed. Of these we have only to say, " Rise above them, 
become mistress of the situation and change your longings." 
If such abnormal cravings come to you in the kitchen, don your 
bonnet and go at once out of doors and take a walk. Don't be 
foolish just because somebody told you foolish stories about 
these things. 

CONSTIPATION 

Bowel hygiene is an important part of the management of 
pregnancy. Constipation often proves to be very troublesome. 
In another chapter this subject is treated at some length. Here, 
we pause only long enough to say that habit has much to do 



COMPLICATIONS OF PREGNANCY 41 

with this difficulty. A regular time should be set apart each 
day for attending to this important matter. 

HEMORRHOIDS 

Of all the maladies that the human family falls heir to, hemor- 
rhoids are among the commonest and, we may add, the most 
neglected. Any woman who enters pregnancy, suffering from 
hemorrhoids, is going to have her full share of suffering and 
pain before she has finished with her labors. Taken early, 
they may be greatly helped, if not entirely relieved, by the 
daily use of the medicated suppository (See Appendix). The 
bowel movements should never be allowed to become hard, the 
dietetic advice of another chapter should be carefully followed 
and the oil enema, as described in the appendix, should be used 
if necessary. For immediate relief, hot witch-hazel compresses 
may be applied; or, in the case of badly protruding piles, the 
patient should immerse the body in a warm bath and by the 
liberal use of vaseline they can usually be replaced. The phy- 
sician should be called and he will advise any further treatment 
the case may require. 

VARICOSE VEINS 

Varicose veins or the distension of the surface veins of the 
legs are very common among women in general and pregnant 
women in particular. The legs should be elevated whenever 
the patient sits, while in bad cases they should be bandaged 
while standing. There are many elastic surgical stockings on 
the market today that, if put on before rising in the morning, 
will give much relief and comfort all during the day. Any large 
medical house or physician's supply house can furnish them 
according to your measurements — which should be taken before 
getting out of bed in the morning. These measurements are 
taken according to instructions and usually are of the instep, 
ankle, calf of leg, length of ankle to knee, etc. 

CRAMPS 

Cramps are sharp, exceedingly painful muscular spasms occur- 
ring in the muscles of the calf of the leg, the toes, etc. The 



42 THE MOTHER AND HER CHILD 

expectant mother in the later months of pregnancy awkwardly 
turns in bed, is suddenly awakened and without a moment's 
warning, is seized with a most excruciating pain in her leg or 
toe. The most effectual treatment for these cramps is quickly 
to apply a very cold object to the cramping muscle. Extremes 
of either heat or cold usually relieve as well as the vigorous 
grasping or kneading of the muscle. A hot foot bath on going 
to bed will often prevent an attack. A long walk in the latter 
months of pregnancy should invariably be followed by a short 
hot bath or a foot bath. Many attacks may be avoided by this 
procedure. 

SWELLINGS 

All swellings should be taken seriously by the pregnant mother 
to this extent, that she save a twenty-four hour specimen of 
urine and that she personally take it to her physician, with a 
report of her " swellings." This symptom may or may not 
indicate kidney complications. The blood-pressure together with 
chemical and microscopical analysis of the urine will determine 
the cause. 

Slight swelling of the feet is often physiological and is due 
to pressure of the heavily weighted uterus upon the returning 
veins of the legs. The progress of the veinous blood is some- 
what impeded, hence the accumulation of lymph in the tissues 
of the legs, ankles, and feet. 

Never allow yourself to guess as to the cause of swellings, 
always take urine to the physician and allow him definitely to 
ascertain the true cause. All tight bands of the waist and knee 
garters must be discarded at this time. The same general 
treatment suggested for varicose veins holds here. 

GOITRE 

The enlargement of the thyroid gland — goitre — is physi- 
ological during pregnancy, and is believed to be caused by the 
throwing into the maternal blood stream of special protein 
substances derived from the fetus. As just stated, this is more 
or less physiological, will usually pass away after the babe is 
born, and, therefore, need give the mother no particular con- 



COMPLICATIONS OF PREGNANCY 



43 



cern. Tight neck bands should be replaced by low, comfortable 
ones. The bowels should move freely every day, and water 
drinking be increased as well as sweating of the skin encour- 
aged by a short, hot bath, followed by the dry blanket pack, 
while the head is kept cool by compresses wrung from cold 
water. In this manner the elimination of these poisons is 
increased through both the skin and the kidneys. 

BACKACHE 

The backache of the later months of expectancy is very 
annoying and often spoils an otherwise restful night's sleep. 




-5 to 7 ft Length 



•9 in. Diameter 



12 in. Diameter 



Fig. 3. The Photophore. 

This is probably also a pressure symptom, if the physician's 
analysis of the urine proves that the kidneys are not at fault. 
If you have electric lights in the home, a very useful contrivance 
can be made which will give you great relief. The light end of 
an extension cord, five to seven feet in length, is soldered into 
the center of the bottom of a bright, pressed tin pail about 
twelve inches in diameter at the top and nine or ten inches 
deep. With the bail removed, screw in a sixteen or thirty-two 
candle power bulb and attach the extension cord to a nearby 



44 THE MOTHER AND HER CHILD 

wall or ceiling socket. This arrangement supplies radiant heat 
and is called a photophore (See Fig. 3). Apply this twofold 
remedial agent — light and heat combined — to the painful back 
(underneath the bed clothing) and our restless mother will go 
to sleep very quickly. This may safely be used as often and as 
long as desired. 

PERNICIOUS VOMITING 

Persistent, prolonged, and very much aggravated cases of 
morning sickness are termed pernicious vomiting. The patient 
emaciates because of the lack of ability to keep food long 
enough to receive any benefits therefrom. 

In treating these cases the sufferer should be put to bed in 
a room with many open windows, or, if the weather permit, 
should be out of doors on a comfortable cot. She should 
remain in bed one hour before the meal is served and from 
one to three hours afterward. The mind should be diverted 
from her condition by good reading, friends, or other amuse- 
ments. The utmost care and tact should be used in the prepara- 
tion of her food, and art should be manifested in the daintiness 
of the tray, etc. We found one mother was nauseated even 
at the sight of her tray and so we planned a call that should 
bring us to her home at the meal hour. The tray came in with 
the attendant in unkempt attire, who said, as she placed it care- 
lessly down on a much-loved book our patient had been reading : 
" I heard you say you liked vegetable soup so I brought you a 
big bowl full." As I gazed at the tray, I saw a large, thick, 
gravy bowl running over with the soup. I usually like vegetable 
soup, but at the sight of that sloppy looking bowl — well, I 
thought I should never care for it again. 

After installing a new maid who had a sense of service and 
daintiness, and who took real pleasure in the selection of the 
dishes for the tray, as well as the quality and quantity of food 
served in them, our patient made speedy recovery, went on to 
full term and became a happy mother. 

There is no doubt that the mind has very much to do with 
this vexing complication of pregnancy. One mother immedi- 
ately stopped vomiting everything she ate when told by her 



COMPLICATIONS OF PREGNANCY 45 

husband that " the doctor said he was coming in the morning 
to take you away from me to the hospital if you didn't stop 
vomiting." Everything known should be tried for the relief 
of these patients and in extreme cases, when the mother's life 
is endangered, pregnancy should be terminated. 

INSOMNIA 

The neutral full bath, temperature 97 F., maintained for 
twenty minutes to one-half hour, should be taken, just on going 
to bed. The patient must not talk — must rest in the bath — 
absolutely quiet. The causes of insomnia should be determined 
if possible, and proper measures employed to remove them. 
They may consist of backache, cramps, frequent urination, 
pressure of the uterus on the diaphragm or pressure against 
the sides of the abdomen. The bed should be large, thus giving 
the patient ample room to roll about. 

The following procedures may be tried in an effort to relieve 
the sleeplessness: 

Rubbing of the spine, alcohol or witch-hazel rubbing of the 
entire body, the neutral bath, or the application of the electric 
photophore — described a few pages back — may be made to 
the painful part. Do not resort to drugs, unless you are directed 
to do so by your physician. 

HEADACHE 

Headaches should not be allowed to continue unobserved by 
the attending physician. Measure the daily output of urine, 
which should be at least three pints or two quarts. In case of 
daily or frequent headaches, notify your physician at once and 
take a twenty-four hour specimen of urine to him. Headache 
is an early symptom of retained poisons and if early reported 
to the physician quick relief can be given the patient and often 
severe kidney complications be avoided by the proper adminis- 
tration of early sweating procedures. Water drinking should 
be increased to two quarts (about ten glasses) a day. Less food 
and more water are the usual indications in the headaches of 
pregnancy. 



46 THE MOTHER AND HER CHILD 

HIGH BLOOD-PRESSURE 

Blood-pressure is called high when the systolic pressure 
registers above 150 to 160 millimeters of mercury. Pressure 
above 165 should be taken seriously and the patient should keep 
in close touch with her physician. Tri-weekly examinations of 
the urine should be made, while eliminating baths should be 
promptly instituted. The subject of blood-pressure in relation 
to pregnancy will be fully dealt with in the next chapter — in 
connection with toxemia, eclampsia, etc. 



CHAPTER VI 

TOXEMIA AND ITS SYMPTOMS 

AT the close of the preceding chapter on the complications of 
l\ pregnancy, brief mention was made of blood-pressure as a 
possible source of anxiety. This chapter will be devoted to a 
further discussion of the subjects of toxemia, eclampsia, con- 
vulsions, and especially blood-pressure — in connection with 
other leading symptoms of these serious complications of preg- 
nancy. 

TOXIC SYMPTOMS 

In a former chapter we learned that the developing child 
nearly doubled its weight in the last two months of pregnancy. 
As the child grows, its metabolic waste matter is greatly 
increased, while all these poisonous substances must finally be 
eliminated by the mother. Now, the mother's waste matter is 
of itself considerably increased; and so, if the kidneys, the liver, 
and the skin are already over-taxed in their work of normal 
elimination — if they are already doing their full quota of 
work — we can readily see that the additional waste matter 
of the unborn child will throw much extra work on the already 
overworked eliminative organs, and this results in a condition 
of toxemia. Certain symptoms accompany this state of consti- 
tutional poisoning or auto-intoxication — ■ the chief of which are : 

i. Headache. 

2. Dizziness. 

3. Blurring of the vision. 

4. Swelling of the feet and hands, or pufnness of the face. 

5. Diminished urine. 

6. Vomiting. 

7. High blood-pressure. 

8. Albumin and casts in the urine. 

47 



48 THE MOTHER AND HER CHILD 

Any one of these symptoms may or may not indicate toxemia ; 
but it should be reported at once to the attending physician. 
In the presence of one or more of these symptoms an expectant 
mother is always safe, while awaiting the physician's advice, 
in carrying out the following program: 

i. Drink more water or lemonade. 

2. Take a mild cathartic. 

3. Avoid eating much meat and other highly protein foods. 

CONVULSIONS OF PREGNANCY 

This serious complication of the last weeks of pregnancy 
demands immediate attention. They may almost invariably be 
avoided if the blood-pressure and the urine are studiously 
watched during the latter part of the expectant period. 

If you are unable to get your physician at once, the following 
treatment should be administered immediately. 

1. A hot colonic flushing (See Appendix). 

2. A hot bath followed by the hot blanket pack (See Appen- 
dix). 

3. One drop of croton oil on a bit of sugar may be placed 
on the back of the tongue. 

4. Chloroform may be administered, provided a competent 
nurse or other medical person is present. 

The appearance of convulsions which have been preceded by 
one or more of the symptoms noted under the head of " tox- 
emia," indicates that the patient has become so profoundly 
intoxicated and poisoned by the accumulating toxins, that the 
lives of both mother and child are jeopardized by threatened 
eclampsia. At such a time, the attending physician will immedi- 
ately set about to bring on labor, and thus seek to empty the 
uterus at the earliest possible moment. 

CARDINAL SYMPTOMS OF TOXICITY 

Since toxemia (eclampsia) is one of the complications of 
pregnancy most to be dreaded, it is fortunate that it almost 
invariably exhibits early danger signals which, if recognized 
and heeded, would enable the patient and physician to initiate 





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TOXEMIA AND ITS SYMPTOMS A9 

proper measures to avert danger and escape the threatened 
disaster. The presence of this toxic danger is indicated by the 
persistent presence of the following three symptoms: 

1. Persistent, dull headache. 

2. Presence of casts in the urine. 

3. Persistent high blood-pressure, with tendency to increase. 

Of course, albumin will probably appear in the urine along 
with the casts, but it is the continued appearance of the casts 
that is of more importance as a danger signal. Albumin is 
quite common in the urine of the expectant mother, but casts 
— long continued — suggest trouble. Headache as an indicator 
of toxemia is of special significance when coupled with the 
other two cardinal symptoms of eclampsia — urinary casts and 
increasing high blood-pressure. Therefore, the necessity for 
frequent urinary tests and blood-pressure examinations during 
the last weeks of pregnancy — especially, if the patient has suf- 
fered from headaches and has been running albumin in the 
urine. 

HIGH BLOOD-PRESSURE 

Blood-pressure is a term used to indicate the actual pressure 
of the blood stream against the walls of the blood vessels. 
The blood-pressure machine tells us the same story about our 
circulatory mechanism, that a steam gauge does about a high- 
pressure boiler (See Fig. 4). The normal blood-pressure varies 
according to the age of the patient. For instance, the normal 
pressure of a young person, say up to twenty years of age, 
runs from 100 to 120 millimeters of mercury; and then, as the 
age advances, the blood-pressure increases in direct ratio; for 
every two years additional age the blood-pressure increases 
about one point — one millimeter. 

The average pregnant woman starts in her pregnancy with 
a blood-pressure of say, 125 millimeters, but as pressure symp- 
toms increase, and as constipation manifests itself, and as the 
circulating fluids are further burdened with the toxins which 
are eliminated from the child, the blood-pressure normally 
increases to about 140 mm., and later, possibly to 150 mm. 



50 THE MOTHER AND HER CHILD 

If the pressure goes no higher, we are not alarmed, for we 
have come to recognize a blood-pressure of 140 as about the 
normal pressure of the pregnant woman. 

There are a number of factors which enter into the raising 
of the blood-pressure. For instance, at any time during the 
pregnancy, if the eliminative organs of the mother are doing 
inefficient work, if she falls a victim to a torpid liver, diseased 
kidneys, decreased skin elimination, or sluggish bowels, then, 
with the added and extra excretions from the child, there is 
superimposed upon the mother far more than the normal 
amount of eliminative work — and then, because of improper 
and incomplete elimination, the blood-pressure is increasingly 
raised. 

ECLAMPSIA PREVENTED 

This whole subject can best be illustrated by relating a story, 
the actual experience of Mrs. A. This patient came to the 
office with a history of Bright's disease (albumin and casts 
in the urine), and chronic appendicitis. While treating her 
for the kidney condition, preparatory to an operation for the 
removal of the troublesome appendix — in the very midst of 
this treatment — she became pregnant, and great indeed was 
our dismay. We entertained little hope of getting both the 
mother and child safely through. Frequent examination of 
urine was instituted, the albumin did not increase and the 
blood-pressure remained at normal — about 124 m m. She 
paid weekly or bi-weekly visits to the office and carefully fol- 
lowed the regime outlined. She drank abundantly of water 
and strictly followed the dietary prescribed. Weeks and 
months passed uneventful, until we approached the last six 
weeks of pregnancy, and then we found to our surprise one 
day that the blood-pressure had made a sudden jump up to 
175 m m., while the urine revealed the presence of numerous 
casts and albumin — in the meantime the albumin had entirely 
disappeared. There were also other urinary findings which 
showed that the liver was not doing its share in the work of 
burning up certain poisons. 

In her home we began the following program: Every day 



TOXEMIA AND ITS SYMPTOMS 51 

we had her placed in a bathtub of hot water, keeping cold cloths 
upon her brow, face and neck, and then, by increasing the 
temperature of the bath, we produced a very profuse perspira- 
tion. She was taken out of this bath and wrapped in blankets, 
thus continuing the sweat. All meat, baked beans, and such 
foods as macaroni and other articles containing a high per cent 
of protein were largely eliminated from her diet. At times 
she did not even eat bread. Her chief diet was fruit, vegetables, 
and simple salads, and yet the albumin and casts continued to 
increase in the urine and the blood-pressure climbed up to 190 
m m. 

As we approached the last two weeks of pregnancy, this 
little woman was taken to the hospital and systematic daily 
treatment with sweating procedures was begun. Among other 
things, she had a daily electric light bath. After each of these 
baths she was wrapped in blankets and the sweating continued 
for some time. Careful estimations of albumin were made daily 
and the blood-pressure findings noted three times a day. During 
the last week of pregnancy she lived on oranges and grapes. 
Day by day she was watched until the eventful hour arrived. 
She went into the delivery room and gave birth to a perfectly 
normal child. The albumin and casts quickly cleared up, the 
blood-pressure lowered, and today the little woman is a fond 
mother of a beautiful baby boy. 

It is hard to estimate what might have taken place had not 
her elimination been stimulated. The blood-pressure was our 
guide. Had the albumin (without casts) appeared in the latter 
weeks of pregnancy with a blood-pressure of 140 or 150 m m., 
we would not have become excited, for the reason that in every 
normal pregnancy there is often present a trace of albumin in 
the latter weeks; but when the blood-pressure jumped to 170 
or 190, then we knew that toxemia — eclampsia — convulsions 
— were imminent. So we have in recent years, come to look 
upon the blood-pressure as an exceedingly important factor — 
as an infallible indicator of approaching trouble — as a red 
signal light at the precipice or the point of danger; and it not 
only warns us of the danger, but it tells us about how near 
the boilers are to the bursting point. The glassy eye, the head- 



52 THE MOTHER AND HER CHILD 

ache, the full bounding pulse and the blurring of vision, are 
all symptoms accompanying this high blood-pressure, so that 
in these enlightened days no practitioner can count himself 
worthy the name, or in any way fit to carry a pregnant woman 
through the months of waiting, unless he sees, appreciates, 
and understands the value of blood-pressure findings in 
pregnancy. 



CHAPTER VII 
PREPARATIONS FOR THE NATAL DAY 

TWO months before baby is to arrive, the expectant mother 
should pay particular attention to the conservation of her 
strength. The woman who is compelled to leave her home for 
the factory, the laundry, the office, or other place of employ- 
ment, should stop work during these last two or three months. 
The active club woman should pass the burdens on to others, 
and the woman of leisure should withdraw from active social 
life with its varied obligations. During the final weeks of preg- 
nancy, the prospective mother needs the same hygienic care 
regarding fresh air, exercise, diet, and water drinking, as out- 
lined in a former chapter. 

THE FINAL WEEKS 

As the gravid uterus rises higher in the abdomen, increased 
pressure is exerted on the stomach, the lungs, and upon the 
nerve centers of the back; and it is because of this situation, 
that the duties and obligations of the prospective mother should 
be reduced to a minimum, that she may feel at liberty to lie 
down several times during the day on the porch or in a well- 
ventilated room, in the midst of the best possible surroundings. 
Sexual intercourse should be largely discontinued during the 
last months of pregnancy. 

I sometimes wish the prospective mothers in our dispensary 
districts might have some of the care and the kind treatment 
which is bestowed upon an ordinary prospective mother horse, 
which at least enjoys a vacation from heavy labor, and whose 
food is eaten with calm nerves and in the quietness of a clean 
stall. While the state of the mother's mind does not materially 
influence the child; nevertheless, the state of the mother's body, 

53 



54 THE MOTHER AND HER CHILD 

the weary over-worked muscles and nerves of hot, tired women, 
bending over cook stoves, laundry tubs, or scrubbing floors, does 
materially derange the mother's health and digestion, which in 
turn, reflexly interferes with the growth and physical develop- 
ment of her child. Extra strength is required for the day of 
labor, and since the baby doubles its weight during the last 
two months, the mother is living for two, and should, therefore, 
avoid extreme fatigue, over tiring, and irksome labor during 
these final weeks of watchful waiting. 

SELECTION OF THE HOME 

It may or may not be within the province of prospective 
parents to rearrange, rebuild, or otherwise change the home. 
Usually the size of the pocketbook, the bank account, or the 
weekly pay envelope decide such things for us. The home may 
be in the country or suburbs, with its wide expanse of lawns, 
its hedges of shrubbery, and with its spacious rooms and 
porches ; or it may be a beautifully equipped, modern apartment 
on the boulevard of a city, with its sun parlors, large back 
porches, conveniently located near some well-kept city park, 
or it may be one of those smaller but " snug as a bug in a rug " 
apartments, in another part of the city, where usually there is 
a sunny back porch; or again some of my readers may them- 
selves be, or their friends may be, in a darkened basement with 
broken windows, illy ventilated rooms, with no porches, no 
yards, no bright rays to be seen coming in through windows — 
and yet into all of these varied homes there come little babies 
— sweet, charming little babies, to be cared for, dressed, fed, 
and reared. And we must now proceed to the subject of mak- 
ing the most of what we have — to create out of what we have, 
as best we can, that which ought to be. 

SANITARY PREMISES 

In both the country and city place, yards and alleys should 
be cleaned up. Garbage — the great breeding place of flies — 
should be removed or burned. The manure pile of the stable 
or alley should also be properly covered and cared for. In 
this way breeding places for flies are minimized and millions 



PREPARATIONS FOR THE NATAL DAY 55 

and billions of unhatched eggs are destroyed. In the large 
cities, provision is made for the prompt disposal of garbage, 
and laws are beginning to be enforced regarding the covering 
and the weekly removal of manure, and thus in many of our 
large cities flies are diminishing in numbers each year. Fly 
campaigns and garbage campaigns are teaching us all to realize 
the dangers of infection, contagion, and disease as a result of 
filth; while through the schools, the children of even our foreign 
tongued neighbors take home the spirit of " cleaning up week." 
Even in the rural districts we hope for the dawning of the day 
when filth, stagnant pools, open manure piles, and open privies, 
will be as much feared as scorpions or smallpox. 

ENGAGING THE DOCTOR 

As suggested elsewhere, as soon as the expectant mother is 
aware that she is pregnant, she should engage her physician. 
And since these are days of specialists, he may or may not be 
the regular family doctor. The husband and friends may be 
consulted, but the final choice should be made by the prospective 
mother herself. " The faith which casts out fear, the indefin- 
able sense of security which she feels in her chosen physician, 
supports her through the hours of confinement." Twenty-four 
hour specimens of urine should be saved and taken to the 
physician twice each month and oftener during later months 
of pregnancy. The chosen physician's instructions and sug- 
gestions should be carried out and counsel should be sought 
of him as to the place of confinement. 

THE PLACE OF CONFINEMENT 

There are a number of factors that enter into the selection 
of the place of confinement. In the first place, if the home 
be roomy, bathroom convenient, if the required preparation 
of all necessities for the day of labor can be effected, and it is 
further possible to prepare a suitable delivery-room at home 
with ample facilities for emergencies and complications, and 
you can persuade your physician to do it — then the best place 
in the world for the mother to be confined is within the walls 
of her own home. But such is the case in but one home out 



56 THE MOTHER AND HER CHILD 

of hundreds, and I regret that time and space will not allow me 
to describe and portray the many untimely deaths that might 
have been avoided if this or that supply had only been ready 
at the moment of the unexpected complication of delivery. 
Why should we needlessly risk the lives of prospective mothers, 
when, in every up-to-date hospital delivery-room, all these life- 
saving facilities are freely provided? Here in the modern 
hospital, the mothers from small homes and apartments, the 
mothers who live in stuffy basements, as well as those from 
the average home in the average neighborhood, can come with 
the assurance of receiving the best possible care and attention. 
Every woman who can arrange or afford it, should plan to 
avail herself of the benefits, comforts, quietness, and calm of a 
well-equipped hospital and the surgical cleanliness and safety 
of its aseptic delivery-room. 

Fortunately, the mother of the basement home may have the 
same clean, sterile dressings used upon her as does the mother 
of the boulevard mansion. The maternity ward bed at $8.00 
to $10.00 a week can be just as clean as the bed of the $40.00 
a week room. The methods and procedures of the delivery- 
room can be just as good in the case of the very poor woman 
as in the case of the magnate's wife. In no way and for no 
reason fear the hospital. It is the cleanest, safest, and by far 
the cheapest way. The weekly amount paid includes the board 
of the patient, the routine care, and all appliances and supplies 
of every sort that will be used. Under no circumstances should 
a midwife be engaged. Any reputable physician or any intel- 
lectual minister will advise that. Let your choice be either the 
hospital or the home; but always engage a physician, never a 
midwife. 

THE NURSE 

After selecting the place of confinement, the question of the 
nurse may next be considered. If it is to be the hospital, you need 
give little further thought to the nurse, for your physician will 
arrange for the nurse at the time you enter the hospital. She 
will be a part of the complete service you may enjoy. You 
will find her on duty as you, quietly resting in your room, awaken 



PREPARATIONS FOR THE NATAL DAY 57 

in the sweet satisfaction that at last it is all over — at last your 
baby is here. 

A competent nurse is a necessity, if the confinement takes 
place in the home. She may be a visiting nurse, who, for a 
small fee, will not only come on the day of labor, but will 
make what is known as " post-partum calls " each day for ten 
or twelve days. These are short calls, but are long enough to 
clean up the mother and wash and dress the babe. She is not 
supposed to prepare any meals or care for the home. Then 
there is the practical nurse — women who have prepared them- 
selves along these lines of nursing, whose fees range from 
$12.00 to $18.00 a week. If your physician recommends one 
to you, you may know she is clean and dependable. The 
trained nurse, who has graduated from a three years' course of 
training, is prepared for every emergency, and will intelligently 
work with the physician for the patient's welfare and comfort. 
Her fees range from $25.00 to $35.00 a week. 

Both the practical and the trained nurses are human beings, 
and require rest and sleep the same as all other women do. 
One nurse, after having faithfully remained at her post of duty 
some sixty hours reminded the husband and sister of the 
patient that she must now have five hours of unbroken rest and 
they replied in a most surprised manner, " Why we are paying 
you $30.00 a week, and besides, we understood you were a 
trained nurse." 

The physician usually makes arrangement with the family 
for competent relief for the nurse. She should have at least 
one to two hours of each day for an airing, and six hours out 
of the twenty-four for sleep. 

PREPARATIONS FOR A HOME DELIVERY 

The supplies should all be in the home and ready, as the 
seventh month of pregnancy draws near. In the first place, 
select the drawer or closet shelf where the supplies are to 
remain, untouched, until your physician orders them brought 
out. The supplies requiring special preparation and steriliza- 
tion are: 



58 



THE MOTHER AND HER CHILD 



Three pounds of absorbent 

cotton. 
One large package of sterile 

gauze (25 yards). 
Four rolls of cotton batting. 
Two yards of stout muslin for 

abdominal binders. 
Two old sheets. 



Twelve old towels or diapers. 
One yard of strong narrow tape 

for tying the cord. 
Three short obstetrical gowns 

for the patient. 
Two pairs of extra long white 

stockings. 
Four T-binders. 



Other articles needed by physician, nurse, and patient are 



Fifty bichloride of mercury tab- 
lets (plainly marked "poison"). 

Four ounces of lysol. 

Two ounces of powdered boric 
acid. 

One half ounce of 20% argyrol. 

One quart of grain alcohol. 

One pound jar of surgeon's 
green soap. 

One half pound of castile soap. 

One bottle white vaseline. 

One drinking tube. 

One medicine glass. 

One two-quart fountain syringe. 

One covered enamel bucket or 
slop jar. 



One good sized douche pan. 
Three agateware bowls, holding 

two quarts each. 
Two agateware pitchers, holding 

two quarts each. 
Two stiff hand-brushes. 
One nail file. 

One pair surgeon's rubber gloves. 
One and one-half yards rubber 

sheeting $& inches wide. 
Two No. 2 rubber catheters. 
Two dozen large safety pins. 
Small package of tooth picks, to 

be used as applicators. 
Six breast binders (Fig. 5). 
Six sheets. 



Just before confinement send for one ounce of fluid extract 
of ergot and an original pint bottle of Squibb's Chloroform. 



THE PREPARATION OF THE SUPPLIES 

I. The sanitary pad is used to absorb the lochia after con- 
finement, and needs to be changed many times during the day 
and night; fully five or six dozen will be required. They are 
usually made from cotton batting and a generous layer of 
absorbent cotton.. If made entirely from absorbent cotton they 
mat down into a rope-like condition. They are four and one-half 
to five inches wide and ten inches long. The sterile cheese- 
cloth is cut large enough to wrap around the cotton filling and 
extends at both ends three inches, by which it is fastened 



PREPARATIONS FOR THE NATAL DAY 



59 



to the abdominal binder. With a dozen or fifteen in each 
package these vulva pads are wrapped loosely in pieces of old 
sheets and pinned securely and marked plainly on the outside. 

2. Delivery pads. These pads should be thirty-six inches 
square and about five inches thick, three or four inches of 
which may be the cotton batting and the remainder absorbent 
cotton. Three of these are needed. Each should be folded, 
wrapped in a piece of cloth and likewise marked. 

3. Gauze squares. Five dozen gauze squares about four 
inches in size may be cut, wrapped and marked. These are 
needed for the nipples, baby's eyes, etc. 




3 ft. 

Fig. 5. Breast Binder 



4. Cotton pledgets. These are cotton balls, made as you 
would a light biscuit with the twist of the cotton to hold it in 
shape. They should be about the size of the bottom of a tea- 
cup. These are thrown in a couple of pillow slips and wrapped 
and marked. 

5. The Bobbin. Cut the bobbin or tape into four nine-inch 
lengths and wrap and mark. 

6. The tooth picks are left in the original package and do 
not require sterilization. 

7. Sterilization. Before steaming and baking, wrap each 
bundle in another wrapping of cloth and pin again securely. Mark 
each package plainly in large letters or initials. These packages 
may be sent to the hospital for sterilization in the autoclave 



60 THE MOTHER AND HER CHILD 

or they may be steamed for one hour in the large wash boiler, 
by placing them loosely into a hammock-like arrangement made 
by suspending a firm piece of muslin from one handle of the 
boiler to the other. The center of the hammock should come 
to within five inches of the bottom of the boiler which con- 
tains three inches of boiling water. The cover of the boiler 
is now securely weighed down and the water boils hard for one 
hour, at the end of which time they are removed and placed in 
a warm oven to dry out. The outer wrapping may be slightly 
tinged with brown by this baking. After a thorough drying 
they are allowed to remain in the same wrappings into which 
they were first placed and put away in a clean drawer awaiting 
the "Natal Day." 

REQUISITES FOR THE HOSPITAL 

Each hospital has its own methods and regulations for caring 
for obstetrical patients and it is well for the expectant mother 
to visit the obstetrical section, the delivery-room and the baby's 
room, that she may personally know more about the place where 
she is to spend from ten days to two weeks. Here she may 
ascertain from the superintendent just what she will need to 
bring for the baby. Many of the hospitals furnish all the 
clothes needed for the baby while in the hospital; in such in- 
stances, the hospital also launders them. Other hospitals require 
the baby's clothes to be brought in, in which case the mother 
looks after the laundry. The mother always takes her toilet 
articles, a warm bed jacket with long sleeves, several night 
dresses and a large loose kimono or wrapper to wear to the 
roof garden or porch in the wheel chair. Warm bedroom 
slippers and a scarf for the head completes the outfit. 

BABY'S NECESSITIES 

Baby's basket on the day of confinement should contain: 

One pound of absorbent cotton. A powder box containing pow- 

One pint of liquid albolene. der and puff, 

One half ounce of argyrol An old soft blanket in which to 

(mentioned in the mother's receive the child after birth. 

list). A soft hair brush. 

Safety pins of assorted sizes. Three old towels. 



PREPARATIONS FOR THE NATAL DAY 61 

Small package of sterile gauze A pair of silk and wool stock- 
squares, ings. 

Scales. A flannel skirt. 

Diapers. An outing-flannel night dress. 

A silk and wool shirt '(size A woolen wrapper. 
No. 2). 

An abdominal band to be sewed 
on with needle and thread. 

THE CONFINEMENT ROOM 

By special preparation, the ordinary bedroom may be fash- 
ioned into a delivery-room. Carpets, hangings and upholstered 
furniture must be removed. Clean walls, clean floors, and a 
scrupulously clean bed must be maintained throughout the 
puerperium. Bathroom, and if possible, a porch should be 
near by. In the wealthy home, a bedroom, bathroom and the 
nursery adjoining is ideal; but I find that real life is always 
filled with anything but the ideal. 

The dispensary doctor is compelled to depend upon clean 
newspapers to cover everything in the room he finds his 
patient in. The only sterile things he uses he brings with him, 
and should he have to spend the night, the floor is his only 
bed. A student who was in my service told me that there was 
not one article in the entire home, which consisted of but one 
room, that could be used for the baby. He wrapped his own 
coat about it and laid it carefully in a market basket and 
placed it on the floor at the side of the pallet on which the 
mother lay and by the aid of a nearby telephone secured 
clothes from the dispensary for the babe. 

Always select the best room in the house for a home con- 
finement. If the parlor is the one sunny room, take it; remove 
all draperies, carpet, etc., and make it as near surgically clean 
as possible. While sunshine is desirable, ample shades must 
be supplied, as the eyes of both mother and babe must be 
protected. 

THE BED 

A three-quarter bed is more desirable than a double bed. 
If it is low, four-inch blocks should be placed under each leg, 



62 THE MOTHER AND HER CHILD 

the casters having been removed to prevent slipping. The 
bed should be so placed that it can be reached from either 
side by the nurse and physician. The mattress may be reen- 
forced by the placing of a board under it if there is a tendency 
to sag in the middle. Over this mattress is securely pinned the 
strip of rubber sheeting or- table oilcloth. A clean sheet covers 
mattress and rubber cloth and at the spot where the hips are 
to lie may be placed the large sterile pad to absorb the escap- 
ing fluids. The floor about the bed is protected by newspapers or 
oilcloth. Good lighting should always be provided. Much 
trouble and possible infection may be avoided by clean bedding, 
plenty of clean dressings, boiled water, rubber gloves, and 
clean hands. 



CHAPTER VIII 
THE DAY OF LABOR 

AS the two hundred and seventy-three days come to a close, 
our expectant mother approaches the day of labor with 
joy and gladness. The long, long waiting days so full of 
varied experiences, so full of the consciousness that she, the 
waiting mother, is to bring into the world a being which may 
have so many possibilities — well, even the anticipated pangs 
of approaching labor are welcomed as marking the close of the 
long vigil. These days have brought many unpleasant symptoms, 
they have been days of tears and smiles, of clouds and sun- 
shine. 

THE TIME OF WAITING 

The prospective mother has thought many times, " Will my 
baby ever come?" But nature is very faithful, prompt, and 
resourceful. She ushers in this harvest time under great stress 
and strain, for actual labor is before us — downright, hard 
labor — just about the hardest work that womankind ever 
experiences — and, as a rule, she needs but little help — good 
direction as to the proper method of work and the economical 
expenditure of energy. In the case of the average mother this 
is about all that is needed, and if these suggestions come from 
a wise and sympathetic physician — one who understands and 
appreciates asepsis — she may count herself as fortunately 
situated for the oncoming ordeal. 

In the days of our grandmothers it was almost the exception 
rather than the rule to escape " child-bed fever," " milk leg," 
etc. ; but in these enlightened days of asepsis, rubber gloves, 
and the various antiseptics, puerperal infection is the exception, 
while a normal puerperium is the rule; and this work of pre- 

63 



64 THE MOTHER AND HER CHILD 

vention lies in the scrupulous care taken by anyone and every- 
one concerned in any way with the events of the day of labor. 

On this day of labor, the mother, who has gone through 
the long tedious days of waiting, should see to it that nothing 
unclean — hands, sponges, f orcep, water, cloth — is allowed 
to touch her. Above all things do not employ a physician who 
has earned the reputation of being a " dirty doctor." Puerperal 
infection is almost wholly a preventable disease and every 
patient has a right to insist upon protection against it, 

In a former chapter will be found a detailed description of the 
" delivery bed." Beside this bed, or near by, are to be found 
the rack on which are airing the necessary garments for the 
baby's reception — the receiving blanket and other requisites 
for the first bath — together with numerous other articles essen- 
tial to safety and comfort. 

There should be an easy chair in the room for the mother 
to rest in between her walking excursions during the first 
stages of labor. The sterilized pads and necessary articles men- 
tioned in an earlier chapter are, of course, close at hand. 

FIRST SYMPTOMS OF LABOR 

Regular, cramp-like pains in the lower portion of the abdomen 
which are frequently mistaken for intestinal colic, often begin- 
ning in the lower part of the back, and extending to the front 
and down the thigh, are often the first symptoms of the ap- 
proaching event. With each cramp or pain the abdomen gets 
very hard and as the pain passes away the abdomen again as- 
sumes its normal condition. These regular cramp-like pains 
are the result of the early dilation of the cervix — the first 
opening of the door to the uterine room which has housed our 
little citizen through the developmental stages of embryonic 
life — and as a result of this stretching and dilating there soon 
appears that special blood-tinged mucus flow commonly known 
as "the show." 

THE PRELIMINARY BATH 

At this time a very thorough-going colonic flushing should 
be administered. The patient takes the " knee-chest " position, 



THE DAY OF LABOR 65 

or the " lying-down " position, and there should flow into the 
lower bowel three pints of soapy water ; this should be retained 
for a few moments; and after its expulsion, a short, plain 
water injection should be given. Now follows the preliminary 
general bath. 

Just prior to the bath, the pubic hair should be clipped closely, 
or better shaved. Then should follow a thorough soap wash, 
with patient standing up in the tub, using plenty of soap, applied 
with a shampoo brush or rough turkish mit. The rinsing now 
takes place by either a shower or pail pour. Do not sit down 
in the tub. This is a rule that must not be broken, because of 
the danger of infection in those cases where the bag of waters 
may have broken early in the labor. 

A weak antiseptic solution, prepared by putting two small 
antiseptic tablets into one pint and a half of warm water, is 
now applied to the body from the breasts to the knee. Put 
on a freshly laundered gown, clean stockings and wrapper. The 
head should be cleansed and hair braided in two braids. 

THE PROGRESS OF LABOR 

If all the mothers who read this volume could bear children 
with the comfort Mrs. C. does, I should be happy, indeed. 

At four o'clock one morning a very much excited father 
telephoned me, " Hurry, quick, Doctor, it's almost here." It 
was well that we did hurry, for the first sign the little mother 
had was the deluge of the waters — at this point the husband 
ran to telephone for the doctor — no more pains for thirty- 
eight minutes (just as we entered the door) and the baby 
was there. But such is not usually the case, nor will it be, as labor 
usually progresses along the lines of conscious dilating pains, 
occurring at intervals twenty minutes apart at first, later draw- 
ing nearer together until they are three to five minutes apart. 
This " first stage of labor " lasts from one to fifteen hours — 
during which time the tiny door to the uterine room which 
was originally about one-eighth of an inch open — dilates suf- 
ficiently to allow the passage of the head, shoulders and body 
of the fully developed child. 

About this time the bag of waters usually bursts, and, as a 



66 THE MOTHER AND HER CHILD 

rule, this marks the beginning of the " second stage of labor." 
The amount of water passed varies in amount. Should the 
rupture take place before the door is fully open, then labor 
proceeds with difficulty and the condition is known as " dry 
labor." 

The head after proper rotation now begins the descent; 
and here the pains begin to change from the sharp, lancinating, 
cramp-like pains which begin in the back and move around to 
the front, to those of the " bearing down " variety, while at the 
same time there begins to appear the bulging at the perineum, 
which means that the head is about to be born. At this time 
great stress is brought to bear upon the perineum and often, 
in spite of anything that can be done to prevent it, the perineum 
is more or less lacerated. 

As soon as the baby is born the "second stage of labor " 
has passed and within thirty to fifty minutes the close of the 
third stage of labor is marked by the passage of the placenta 
or " afterbirth." 

FALSE LABOR PAINS 

Sometimes, as long as two weeks before the birth of the 
child, certain irregular, heavy, cramp-like pains occur in the 
abdomen and back. For a half-dozen pains they may show 
some signs of regularity; but they usually die down only to 
start up again at irregular intervals. These are known as 
" false pains." 

When the pains begin to take on regularity and gradually 
grow heavier and it is near the appointed time for the labor, 
the patient should prepare to start for the hospital; or, if it is 
to be a home delivery, the physician should be called. As 
noted above, the first subjective symptom may be the rupture 
of the bag of waters, and it is imperative to prepare at once 
for the labor. It is far better to spend the day at the hospital, 
or even two days waiting, rather than to run the risk of giving 
birth to the child in a taxicab or street car; or, in the event 
of a home labor, to have the child born before the doctor 
arrives. 



THE DAY OF LABOR 67 

WHAT TO DO IN THE ABSENCE OF A DOCTOR 

It is often the case that when we need our physician the 
most, he is busy with another patient and cannot come, or 
perhaps an automobile accident detains the man of the hour. 
The hospital delivery always possesses this advantage over the 
home — physicians are always on hand. We deem it wise to 
relate in detail the method of procedure during the rapid birth 
of a child; that the husband or nurse may give intelligent 
and clean service. 

After the patient has been given the enema and has been 
shaved and the bath has been administered as previously 
directed, the helper most vigorously " scrubs up." There are 
three distinct phases to the " scrubbing up " : First, the three- 
minute scrubbing of the hands and forearms with a clean brush 
and green soap; to be followed by, second, the trimming and 
cleaning of the finger nails, for it is here, under the nails, that 
the micro-organism lives and thrives that causes child-bed 
fever or septicemia; and, third, the final five-minute scrubbing 
of the fingers, hands, and forearms. An ordinary towel is not 
used to dry the well-cleansed hands, but they are now dipped 
in alcohol and allowed to dry in the air. 

And now if the pains are returning every three to five minutes 
or if the bag of waters has broken, the patient should go to 
bed. She will lie down on her back with the knees drawn up 
and spread apart. The patient, having had the cleansing bath, 
is now washed with the disinfectant bath (2 antiseptic tablets 
to 1^2 pints of water), from the breasts to the knees. Another 
member of the family takes the outer wrappings off the 
sterilized delivery pad and the " clean " helper places the sterile 
delivery pad under the expectant mother, who is directed to 
" bear down " when her pains come. She may be supported 
during these pains by pulling on a sheet that has been fastened 
to the foot of the bed. 

The clean helper then sits by her constantly until the baby 
is born but under no circumstances should touch her until after 
the head appears. Immediately after the birth of the head, the 
shoulders usually follow with the next pain, which ought to 



68 THE MOTHER AND HER CHILD 

occur within two or three minutes. Occasionally the face turns 
blue, in such an instance, the mother is directed to strain 
vigorously and presses down heavily on the abdomen with 
both her hands, this usually hurries matters materially, and the 
body of the child follows quickly. The baby should cry at 
once. If the child does not show signs of life, quick, brisk 
slapping on the back usually brings relief. During the birth 
of the head it is imperative that, in the event of liquid passing 
at the same time, no water or blood be sucked into the mouth 
by the baby. Great care must be exercised in this matter. 
Should the baby remain blue, lay it quickly upon its right side 
near the mother, and after the pulse of the cord has stopped 
beating the clean helper ties the cord twice, two inches from 
the child and again two inches from this tying toward the 
mother, and then the cord is cut between the two tyings with 
scissors that have been boiled twenty minutes. 

Should there be more difficulty with the breathing of the 
new born child, if slapping it on the back brings no relief, its 
back (with face well protected) may be dipped first in good 
warm water, then cold, again in the warm, again in the cold — 
this seldom fails. The child should then be kept very warm, 
lying on its right side. 

CARE OF THE MOTHER 

All this time, a member of the family has been firmly grasp- 
ing the mother's abdomen, and within an hour the afterbirth 
passes out through the birth canal. If the physician has not 
yet arrived, all dressings, the pad, the afterbirth, must all be 
saved for his inspection. 

The inside of the thighs and the region about the vagina is 
now washed with bichloride solution, the soiled delivery pad 
removed, a clean delivery pad is placed under her; an abdom- 
inal binder is applied and two sterile vulva pads are placed 
between the legs, and hot water bottles are put to her feet, as 
usually at this stage there is a slight tendency toward chilliness. 
She should now settle down for rest. Fresh air should be ad- 
mitted into the room. There may be some hemorrhage, and 
if it is excessive, grasp the lower abdomen and begin to knead 



THE DAY OF LABOR 69 

it until you distinctly feel a change in the uterus from the soft 
mass to a hard ball about the size of a large grape fruit; thus 
contraction has been brought about which causes the hemor- 
rhage to decrease. If the doctor has not yet arrived put the 
baby to the breast, and place an ice bag for ten or fifteen 
minutes on the abdomen just over the uterus. Should there 
be lacerations, the doctor will attend to their repair when he 
comes. One teaspoonful of the fluid extract of ergot is usually 
given at this time, if possible get in touch with the physician 
before it is administered. 

CARE OF THE BABY 

After the mother is comfortable, your attention is directed 
to the baby; the condition of the cord is noted; should it be 
bleeding, do not disturb the tying, but tie again, more tightly 
just below the former tying, and with the long ends of the 
tape, tie on a sterile gauze sponge or a piece of clean untouched 
medicated cotton, thus efficiently protecting the severed end of 
the cord. No further dressing is needed until the doctor 
arrives. 

Grave disorders have arisen from infection through the 
freshly cut umbilical cord. 

Should the doctor be longer delayed, one drop of twenty 
per cent argyrol should be dropped in each of the infant's 
eyes and separate pieces of cotton should be used for each 
eye to wipe the surplus medicine away. 

This application must not be long neglected, for a very large 
per cent of all the blindness in this world might have been 
avoided had this medicine been placed in each eye soon after 
birth. 

The warmed albolene is now swabbed over the entire body 
of the infant (this is done with a piece of cotton), the arm 
pits, the groins, behind the ears, between the thighs, the bend 
of the elbow, etc., must all receive the albolene swabbing. In 
a few minutes, this is gently rubbed off with a piece of gauze 
or an old soft towel, and the baby comes forth as clean and as 
smooth as a lily and as sweet as a rose. 

The garments are now placed on the child — first the band, 



70 THE MOTHER AND HER CHILD 

then shirt, diaper, stockings, flannel skirt, and outing flannel 
gown — and it is put to rest after the administration of one 
teaspoonful of cooled, boiled water. In six to eight hours 
it will be put to the breast. 



CHAPTER IX 
TWILIGHT SLEEP AND PAINLESS LABOR 

IN recent years much has appeared in both the popular mag- 
azines and the medical press concerning the so-called " twi- 
light sleep " and other methods of producing " painless child- 
birth." Many of these popular articles in the lay press cannot 
be regarded in any other light than as being in bad taste and 
wholly unfortunate in their method and manner of presenting 
the subject; nevertheless, these writings have served to arouse 
such a general public interest in the subject of obstetric 
anesthetics, that we deem it advisable to devote two chapters 
to the brief and concise consideration of the subjects of pain 
and anesthetics in relation to the day of labor. 

THE PAIN OF LABOR 

First, let us briefly consider the question of pain in con- 
nection with childbirth. Many women — normal, natural, and 
healthy women — suffer but comparatively little in giving birth 
to an average-sized baby during an average and uncomplicated 
labor. Like the Indian squaw, they suffer a minimum of pain 
at childbirth — at least this is largely true after the birth of 
the first baby; and so there is little need of discussing any sort 
of anesthesia for this group of fortunate women ; for at most, 
all that would ever be employed in the nature of an anesthetic 
in such cases, would be a trifle of chloroform to take the edge 
off the suffering at the height or conclusion of labor. 

But the vast majority of American mothers do not belong to 
this fortunate and normal class of women who suffer so little 
during childbirth; they rather belong to that large and growing- 
class of women who have dressed wrong; who have lived un- 
healthful and sometimes indolent lives; who are more or less 

7i 



72 THE MOTHER AND HER CHILD 

physically and temperamentally unfitted to pass through the 
experiences of pregnancy and the trials of labor. 

The average American woman shrinks from the thought and 
prospect of suffering pain ; she is quite intolerant with the idea 
of undergoing even the few brief moments of physical suffer- 
ing attendant upon childbirth. She refuses to contemplate the 
day of labor in any other light than that which insures her 
against all possible pain and other physical suffering. 

And it is just this unnatural and abnormal fear of labor- 
pains — this unwomanly dread of the slightest degree of 
physical suffering — that has indirectly led up to so much dis- 
cussion regarding the employment of " twilight sleep " and 
other forms of obstetric anesthesia. 

While the authors recognize the great blessing of anesthesia 
to the woman in labor — and almost unfailingly make use of 
it in some form — nevertheless, we also recognize that it would 
be a fine form of mental discipline and mighty good moral 
gymnastics, if a great many self-centered and pampered women 
would " spunk right up " and face the ordeal of labor with 
natural courage and normal fortitude. It would be " the mak- 
ing of them," it would make new women out of them, it would 
start them out on the road to real living. At the same time 
we do not mean to advocate that women should suffer unneces- 
sary pain in childbirth any more than we allow them to suffer 
in connection with surgery. 

PREPARATION FOR LABOR 

While so much is being written about " twilight sleep " and 
" painless labor," it might be well to remind the American 
mother that much can be done to lessen the sufferings of the 
day of labor by one's method of living prior to the confine- 
ment. 

We believe that child-bearing is a perfectly normal physical 
function for a healthy and normal woman — that it is even es- 
sential to her complete physical health, mental happiness, and 
moral well-being. Theoretically, child-bearing ought to be but 
little more painful than the functionating of numerous other 
vital organs — stomach, heart, bladder, bowels, etc. — and, in- 



TWILIGHT SLEEP AND PAINLESS LABOR 73 

deed, it is not in the case of certain savage tribes and other 
aboriginal people, such as our own North American Indian. 

But we must face the facts. The average American woman 
does suffer at childbirth; and she suffers more than we are 
disposed to allow her, or more than she, as a general rule, is 
willing to suffer. So, while we discuss appropriate methods 
of lessening the pain of labor and the pangs of childbirth by 
the scientific use of anesthetics, let us also call attention to 
certain things which may aid in decreasing the amount of pain 
which may reasonably be expected to attend child bearing. 

To assist in bringing about this preparation for decreased 
pain at childbirth, mothers should teach their daughters how 
to develop, strengthen, and preserve their physical, mental, and 
moral resistance. The young mother should be taught by both 
her mother and her physician how to dress, how to work, and 
how to eat. Every care should be given to the hygiene of 
pregnancy and labor. 

The expectant mother should have plenty of fruits and fruit 
juices, and if not physically well endowed to give birth to a 
large babe, she should have her diet restricted in meat, bread 
and milk, as well as the cereals. Overeating during preg- 
nancy should be carefully guarded against, as emphasized in 
an earlier chapter. Deformities of the pelvis, etc., should rule 
out a consideration of pregnancy. 

While artificial painless childbirth by means of " twilight 
sleep " and other similar methods all have their place ; neverthe- 
less, these procedures should not lead to the neglect of those 
natural methods and preventive practices which aid in pre- 
paring the normal expectant mother for nature's relatively 
painless labor. When so much anesthesia has to be used in a 
normal labor, it cannot but strongly suggest that both patient 
and physician have neglected those common but efficient 
methods which contribute indirectly to lessening the pangs of 
child bearing. 

WHAT IS TWILIGHT SLEEP? 

" Twilight sleep " is a recent term which has become asso- 
ciated in the public mind with " painless labor." The reader 



74 THE MOTHER AND HER CHILD 

should understand that " twilight sleep " is not a new method 
of obstetric anesthesia. While this method of inducing 
" painless labor " has been brought prominently before the 
public mind in recent years by much discussion and by numerous 
magazine articles — being often presented in such a way as 
sometimes to lead the uninstructed layman to infer that a new 
method of obstetric anesthesia had just been discovered — it 
has, nevertheless, been known and more or less used since 1903, 
Later known as the " Freiburg Method," and as the " Dammer- 
schlaf " of Gauss, and still later popularized as " twilight 
sleep," this " scopolamin-morphin " method of obstetric 
anesthesia, has gained wide attention and acquired many zealous 
advocates. 

" Twilight sleep " is, therefore, nothing new — it is simply 
a revival of the old combination of scopolamin and morphin 
anesthesia. While many different methods of administering 
" twilight sleep " have been devised, the following general plan 
will serve to inform the reader sufficiently regarding the tech- 
nic of this much-talked-of procedure. 

The scopolamin must always be fresh, although different 
forms of the drug are used. It tends quickly to decompose — 
forming a toxic by-product — and, according to some author- 
ities, this decomposed scopolamin is responsible for many un- 
desirable results which have attended some cases of " twilight 
sleep." Various forms of morphin are also used, as also is 
narcophin. 

TECHNIC OF " TWILIGHT SLEEP " 

The "twilight-sleep" injections are not started until the 
patient is in the stage of active labor. The initial injection 
consists of the proper dose of scopolamin and morphin (or 
some of their derivatives), while the patient's pupils, pulse, and 
respiration are carefully noted, as also are the character of 
the uterine contractions and the character of the fetal heart 
action. 

Usually within an hour, a second dose of scopolamin is given, 
while the application of so-called " memory tests " serves to 
indicate whether it is advisable to administer additional injec- 



TWILIGHT SLEEP AND PAINLESS LABOR 75 

tions. Some leading advocates of this method claim that the 
majority of the unfavorable results attendant upon " twilight 
sleep " are the direct result of failure to control the dosage 
of the drug by these " memory tests ; " and they call attention 
to the large percentage of " painlessness " as proof of probable 
overdosing. If the patient's memory is clear and she is not 
yet under the influence of the drug, a third dose is soon given. 
If, however, the patient is in a state of amnesia (lack of 
memory), this third injection is not commonly given mi til 
about one hour after the second injection. The amount of 
amnesia present is used as a guide for repeated injections at 
intervals of one to one and a half hours. As a rule, the mor- 
phin is not repeated. 

It must be evident that the success of such a method of 
anesthesia must depend entirely upon thoroughgoing personal 
supervision of the individual patient by a properly trained 
and experienced physician; and it is for just these reasons 
that " twilight sleep " is destined to remain largely a hospital 
procedure for a long time to come. 

Experience has shown that those cases of " twilight sleep " 
that are not under the influence of scopolamin over five or six 
hours do vastly better than those under a longer time. When 
employed too long before labor this method seems to favor 
inertia and thus tends to increase the number of forceps 
deliveries. 

The number of injections may run from one to a dozen or 
more, and patients have come through without accident with 
fifteen or more doses, running over a period of twenty-four 
hours. 

THE CLAIMS OF " TWILIGHT SLEEP " 

While " twilight sleep " as a method of anesthesia is not alto- 
gether new, many of the claims made for it by recent advocates 
are more or less new; and, to enable the reader clearly to com- 
prehend both the advantages and disadvantages of this method, 
both the favorable and unfavorable facts and contentions will 
be summarized in this connection. The favorable claims made 
for " twilight sleep " are : 



y6 THE MOTHER AND HER CHILD 

i. That eighty to ninety per cent of all women who use this 
method can be carried through a practically painless labor. 

2. That there is practically no danger to the mother (some 
degree of danger to the child is admitted by most of its cham- 
pions) other than those commonly attendant on the older and 
better known methods in general use. 

3. That "twilight sleep," being almost exclusively a hospital - 
procedure, would result in more women going to the hospital 
for their confinement — if it were used more; and would, there- 
fore, tend to bring about more careful supervision and individual 
care on the part of the attending obstetrician. 

4. That by lessening the dread of labor and the fear of 
painful childbirth, there will probably occur an increase in the 
birth rate of the so-called "higher classes of society" — the 
social circles which now show the lowest birth rates. 

5. That it is of special value in the cases of certain neurotic 
women and those of low vital resistance ; especially those patients 
suffering from certain forms of heart, respiratory, kidney, and 
other organic diseases. 

6. Some , authorities maintain that " twilight sleep " is of 
value even in threatened eclampsia, although they admit it tends 
to produce a rise in blood-pressure. 

7. It is supposed to shorten the first stage of labor — by 
facilitating the dilation of the cervix — owing to the painless 
stretching; although the majority of its special advocates admit 
that it lengthens the second stage of labor, during which the 
patient must be very closely watched. 

8. That even in those cases where the sense of pain is not 
entirely destroyed, the patient seems to possess little or no 
subsequent memory of any physical suffering or other disagree- 
able sensations. 

9. That the method is of special value in sensitive, high- 
strung, nervous women of the " higher classes," who so habit- 
ually shun the rigors of child bearing — especially in the in- 
stance of their first child. 

10. That the action of scopolamin is chiefly upon the central 
nervous system — the cerebrum — that it diminishes the per- 
ception of pain without apparently decreasing the contractile 



TWILIGHT SLEEP AND PAINLESS LABOR 77 

power of the uterus; labor may, therefore, proceed with little 
or no interruption, while the patient is quite oblivious to the 
accompanying pains. 

11. That the physical and nervous exhaustion is quite en- 
tirely eliminated — especially in the case of the first labor — 
that patients who have had this method of anesthesia appear 
refreshed and quite themselves even the first day after labor. 

12. That there is decidedly less "trauma" (appreciable 
injury) to the nervous system and therefore less " shock; " and 
that all this saving of nervous strain tends greatly to hasten 
convalescence. 

13. And, finally, that " twilight sleep " does not interfere 
with the carrying out of any other therapeutic measures which 
may be deemed necessary for a successful termination of the 
labor. 

DANGERS OF TWILIGHT SLEEP 

While we are recounting the real and supposed advantages 
of " twilight sleep " — especially in certain selected cases — it 
will be wise to pause long enough to give the same careful 
consideration to the known and reputed dangers and drawbacks 
which are thought to attend this method of anesthesia in con- 
nection with labor cases. 

We desire to state that these expressions, both for and 
against " twilight sleep," are not merely representative of our 
own experience and attitude; but that they also represent, as 
far as we are able to judge at the time of this writing, the 
consensus of opinion on the part of the most reliable and 
experienced observers and practitioners who have used and 
studied this method in both this country and Europe. The 
dangers and difficulties of " twilight sleep " may be summarized 
as follows: 

1. That this method tends to weaken the mental resistance 
of many women ; to lessen their natural courage and to decrease 
that commendable fortitude which is such a valuable feature 
of the character endowment of the normal woman. 

2. That " twilight sleep " is essentially a hospital method and 
is, therefore, inaccessible to the vast majority of women belong- 



78 THE MOTHER AND HER CHILD 

ing to the middle and lower classes of society, as well as to 
those women who live in rural communities. 

3. That in fifteen or twenty per cent, the method fails to 
produce the desired results — at least, when administered in 
amounts which are deemed safe. 

4. That this method does decrease the baby's chances of 
living; that the second stage of labor is definitely prolonged; 
that from ten to fifteen per cent of the babies are sufficiently 
under the influence of the anesthesia when born as to be unable 
to breathe or cry without artificial stimulus. 

5. That it is a method requiring special training and expe- 
rience; that it will be many years before the average practi- 
tioner will become proficient in its use; and that the older 
methods are probably far safer for the average physician. 

6. That the method requires more care in its administration 
than can be expected outside of the hospital in order to avoid 
the dangers of fetal asphyxiation — which danger has led 
not a few obstetricians to abandon it. 

7. That a satisfactory technic is almost impossible of de- 
velopment; that every patient must be individualized; that the 
chief dangers are connected with the over dosage of morphin; 
that the method is not adaptable to the general practice of the 
average doctor. 

8. That by prolonging the second stage of labor and by 
sometimes giving too much morphin, the number of forceps 
deliveries is greatly increased, with their attendant and in- 
creased, dangers to both mother and child. 

9. That the prospects of passing through labor which may be 
rendered painless by artificial methods, tends to produce an atti- 
tude of carelessness and indifference towards those natural- 
methods of living and other hygienic practices which so greatly 
contribute to naturally painless confinements. 

10. That this method as sometimes practiced greatly increases 
the dangers of a general anesthetic, if such should be found 
necessary later on during the labor. 

11. That "twilight sleep" is contra-indicated (should not 
be used) in the following conditions: primary inertia (abnor- 
mally delayed and slow labor); expected short labor — espe- 



TWILIGHT SLEEP AND PAINLESS LABOR 79 

cially in women who have already borne children; when the 
fetal head is known to be large and the mother's pelvis small; 
placenta praevia (abnormal placental attachment) ; accidental 
hemorrhage; absent or doubtful fetal heart beat; when labor 
is already far advanced; and in threatened convulsions and 
eclampsia. 

CONCLUSIONS REGARDING TWILIGHT SLEEP 

Having presented the evidence both for and against " twi- 
light sleep," it may be of assistance to the lay reader to have 
placed before her the personal conclusions and working opinions 
of the authors. We, therefore, undertake to summarize our 
present attitude and outline our practice as follows: 

1. " Twilight sleep " as a method of obstetric anesthesia in 
certain selected cases and in well-equipped hospitals, and in the 
hands of careful and experienced practitioners, has demon- 
strated that it is a scientific reality — and has probably come 
to stay — at least until better and safer methods of affecting a 
relatively painless confinement are discovered; although we are 
compelled to state that it is not the panacea the lay press has 
led many of our patients to believe. (That we believe a much 
better and safer method has been devised, the next chapter 
will fully disclose.) 

2. We do not expect this method ever to become general 
in its use; we do not look for a chain of special "twilight hos- 
pitals " to stretch across the continent and then to overrun the 
country. We expect much of the recent forced enthusiasm to 
die down, while scopolamin-morphin anesthesia takes it proper 
place among other scientific methods of alleviating the pangs 
of labor. 

3. We know that standard and fresh solutions — as already 
noted — are absolutely essential for the success of this method. 

4. We are certain that no routine method or technic can 
be developed. Each patient must be individualized. The method 
does not consist in injecting scopolamin every so often. The 
patient's mental and physical condition — as also that of the 
unborn child — must control the administration of " twilight 
sleep." 



80 THE MOTHER AND HER CHILD 

5. The patient must be in a quiet and partially darkened 
room. She must not be disturbed; while the physician, or a 
competent trained nurse, must be in constant attendance. 

6. While this method of treatment is best carried out in the 
well-appointed hospital, there is no real reason why it cannot 
be fairly well carried out in a well-regulated private home, 
provided the necessary preparations have been made, a trained 
nurse is present, and provided, further, that the physician is 
willing to remain in the home with the patient the length of 
time required properly to supervise the treatment. 

7. Even when the treatment is not instituted early in labor, 
it can, in certain selected and appropriate cases, be utilized even 
in the second stage of labor — thus saving these special cases 
much unnecessary pain ; in fact, some authorities regard it as 
a valuable adjunct in the management of " borderland con- 
tractions " as it allows the patient a full test of labor. 

8. In our opinion, his method has little effect on the first 
stage of labor if properly administered; but it does undoubtedly 
prolong and tend to complicate the second stage ; in fact, we 
are coming to look upon " twilight sleep " as being more dis- 
tinctly a first stage procedure; that it bears the same relation 
to the first stage of labor that chloroform bears to the second 
stage — relieving the pain but not stopping the progress of labor. 

9. That when safe amounts of the drug are used the pain 
is greatly lessened in all cases — the subsequent memory of pain 
is absent in the majority of the patients — but the labor is not 
always entirely painless as is popularly supposed. 

10. We do not believe that this method when properly ad- 
ministered increases the number of forceps deliveries — at least 
not in the case of high forceps operations. It undoubtedly does 
cover up the symptoms of a threatened rupture of the uterus, 
and thus increases danger from that source; nevertheless it 
may be safely stated that this method does not in any way 
greatly interfere with any other measures which might be 
found necessary to institute in order to bring about a success- 
ful termination of the labor. 

11. The baby's heart beat must be carefully and constantly 
watched; sudden slowing means that the treatment must be dis- 



TWILIGHT SLEEP AND PAINLESS LABOR 81 

continued and the child delivered as soon as possible ; even then, 
difficulty may be experienced in getting the baby's breathing- 
started after it is born. In the vast majority of cases where the 
baby does not cry or breathe at birth, the usual methods em- 
ployed in such cases serve quickly to establish normal respira- 
tion, and the baby seems to be but little the worse for the 
experience. 

12. While altogether too much has been claimed for " twi- 
light sleep " at the same time many false fears have also been 
suggested, among which may be mentioned the fear of the mother 
losing her mind after the treatment; the undue fear of asphyxia- 
tion on the part of the baby; the fear of post-partum hemor- 
rhage; and the fear that it will lessen the milk supply. We cannot 
deny that the child's dangers are often increased; but in other 
respects, this method (in properly selected cases) presents 
little more to worry us than the older methods of anesthesia. 

13. We are inclined to the belief that this method has but 
little influence on the course of convalescence following labor. 
Certain nervous and highly excitable women certainly seem to 
do better, as a result of experiencing less pain and nervous 
shock; while other cases do not turn out so well. It certainly 
does not retard repair and recovery during the puerperium. 

14. This method seems to have its greatest field of useful- 
ness in those cases of highly intelligent but excessively neurotic 
women who have an abnormal dread of pain and child bearing; 
or women who have suffered unusually at the time of a previous 
confinement — perhaps in the case of the first baby — or from 
other complications; women such as these, and other special 
cases, are the ones to benefit most from the employment of 
" twilight sleep." 

15. This method as has already been intimated, is most useful 
in the case of the first baby, or in the case of women who have 
established a record of tedious and painful labors. It has no 
place in normal and short labors; although it may be used to 
great advantage in certain cases during the first stage of labor 
— being carefully and lightly administered — while chloroform 
or gas is utilized at the end of the second stage just as has been 
our custom for a s;eneration. 



82 THE MOTHER AND HER CHILD 

16. As noted under the special claims made for this method, 
it is (as also is nitrous oxid) the ideal procedure in cases of 
heart, respiratory, kidney, and other organic difficulties, the 
details of which have already been noted, and their repetition 
here is not necessary. 

17. It must be remembered that scopolamin and morphin are 
more or less uncertain in their action; scopolamin is variable 
in its results, often producing such marked nervous excite- 
ment in the patient as greatly to interfere with the carrying out 
of an aseptic technic; while morphin has been shunned by ob- 
stetricians for a whole generation, because of its well-known 
bad effects on the unborn child as well as its interference with 
muscular activity on the part of the mother. 

In Germany, it is said, that a great many damage suits 
against prominent physicians have resulted because of the 
alleged ill effects which have followed the use of " twilight 
sleep." 

18. In presenting these facts and opinions regarding "twi- 
light sleep," the reader should bear in mind that we are not 
only endeavoring to state our own views and experience, but 
also to give the reader just as clear and fair an idea of what 
other and experienced physicians think of the method, both 
favorably and unfavorably; and we will draw these conclusions 
to a close by citing the opinion of one or two who have had 
considerable experience with the method and who, in summing 
up their observations, say: 

The disadvantages of the method are entirely with the accoucheur 
and not to the mother or child. It requires his presence at the bed- 
side from the time the treatment is undertaken until the completion 
of labor, not so much because of any danger, but to keep the patient 
evenly under anesthesia on a line midway between consciousness 
and unconsciousness, for if she is allowed to go above that line in 
several instances she will have several so-called "isles of memory," 
and will be able to draw a picture of her labor in her mind and 
thus lose the benefit of the treatment. 

These methods of anesthesia are very important and have merit. 
They should be used when properly indicated. No one should limit 
himself to a routine method. Each case should be individualized 



TWILIGHT SLEEP AND PAINLESS LABOR 83 

and the form of anesthesia best suited to the case in hand should be 
employed. For instance, in dealing with a primipara — one who is 
full of fear, who cannot stand pain, who is of an hysterical nature — 
morphin-scopolamin anesthesia is best suited in that particular case, 
because these drugs have a selective action when it comes to allay 
fear and produce amnesia. On the other hand, in a multipara who 
has had three or four children, whose soft parts are relaxed and 
who has short labors, the anesthetic of choice would be a few 
whiffs of chloroform as the head passes over the perineum. It is 
ridiculous to try to give such women the " twilight sleep." Further- 
more, take the cases you see for the first time at the end of the first 
stage of labor, or during the second stage; these cases are best 
treated with the nitrous oxid and oxygen method. You have to indi- 
vidualize your cases. The prospective mother now consults the 
obstetrician early to find out if her particular case is suitable for the 
" twilight sleep." She has been informed that certain examinations — 
urine, blood pressure, etc. — are necessary. She knows that these 
examinations have to be made at regular intervals. In other words, 
we get the patients early and we can give them good prenatal care. 

This chapter has been devoted to " twilight sleep ; " the fol- 
lowing chapter will consider " nitrous oxid " and other methods 
of anesthesia in connection with labor, and should be read along 
with the foregoing discussion in order to obtain an intelligent 
view of the whole subject of " painless labor." 



CHAPTER X 
SUNRISE SLUMBER AND NITROUS OXID 

SINCE the public has already been told so much about ob- 
stetric anesthesia, we deem it best to go into the whole 
subject thoroughly, so that the expectant mothers who read this 
book will be able to form an intelligent opinion regarding the 
question, and thus be in a position to give hearty cooperation 
to the decision of their physician to employ, or not to employ, 
any special form of anesthesia or analgesia in their particular 
case. In order to give the reader a complete understanding of 
" painless labor," it will be necessary to give attention to that 
newer and more safe method of obstetric anesthesia called 
" sunrise slumber." This method of anesthesia consists in the 
employment of nitrous oxid or " laughing gas," and will be 
fully considered in this chapter. 

OBSTETRIC FEAR 

In this connection we desire to reiterate and further emphasize 
some statements made in the preceding chapter concerning the 
unnatural fear and abnormal dread of childbirth. 

We feel that it is very important in connection with this 
new movement in obstetrics to reduce the woman's pain and 
suffering to the lowest possible minimum, that the trials of 
labor should not be overdrawn and the pangs of confinement 
overestimated. We must not educate the normal woman to 
look upon labor as a terrible ordeal — something like a major 
surgical operation — which, since it cannot be escaped, must 
be endured with the aid of a deep anesthesia. 

The facts are that a very small per cent of healthy women 
suffer any considerable degree of severe pain — at least not 
after the first child. We often observe that judicious mental 

8 4 



SUNRISE SLUMBER AND NITROUS OXID 85 

suggestion on the part of the physician or nurse in the form of 
encouraging words and supporting assurances tends to exert 
a marked influence in controlling nervousness and subduing the 
sufferings of the earlier labor pains. 

We must not allow the efforts of medical science to lessen the 
sufferings of child-bearing, to rob womankind of their natural 
and commendable courage, endurance, and self-reliance. 

We do not mean to perpetuate the old superstition that pain 
and suffering are the necessary and inevitable accompani- 
ments of child-bearing — that the pangs of labor are a divine 
sentence pronounced upon womankind — and that, therefore, 
nothing should be done to lessen the sufferings of confinement. 
Severe and unnatural pain is not at all necessary to childbirth, 
and there exists no reason under the sun why women should 
suffer and endure it, any more than they should suffer the hor- 
rors of a very painful surgical operation without an anesthetic. 
In this connection, it should be recalled that analgesic drugs have 
been introduced into obstetric practice only during the last fifty 
years, while such methods of relieving pain have been used 
in general surgery for a much longer period. It is now only 
sixty-nine years since Simpson first employed anesthetic in 
obstetrics, while six years afterwards Queen Victoria gave her 
seal of approval to the use of chloroform in labor cases. 

Thirty years ago, in speaking of the expectant mothers, Lusk 
warned us: 

As the nervous organization loses in the power of resistance as 
the result of higher civilization and of artificial refinement, it 
becomes imperatively necessary for the physician to guard her from 
the dangers of excessive and too prolonged suffering. 

NITROUS OXID ^LAUGHING GAS " 

Nitrous oxid, or " laughing gas," was first used in labor cases 
in 1880 by a Russian physician. During the last twenty-five 
years it has been used off and on by numerous practitioners in 
connection with confinement, but not until the last few years 
has this method of relieving labor pain come into prominent 
notice. 

While the " laughing gas " method of obstetric anesthesia did 



86 THE MOTHER AND HER CHILD 

not gain notoriety and publicity from being exploited in mag- 
azines and other lay publications, it did get its initial boost 
in a very unique and unusual manner. A gentleman who 
manufactured and sold a " laughing gas " and oxygen mixing 
machine for the use of dentists, insisted that this method of 
anesthesia should be used in the case of his daughter, who was 
about to be confined. This patient was kept under this nitrous 
oxid anesthetic for six hours — came out fine — no accidents 
or other undesirable complications affecting either mother or 
child, and thus another and safe method of reducing the suf- 
ferings of childbirth has been fully demonstrated and confirmed, 
although it had previously been known and used in labor cases 
to some extent. 

Starting from this particular case in 1913, many obstetricians 
began experimental work with " gas " in labor cases ; and, at 
the time of this writing, it has come to occupy a permanent place 
in the management of labor, alongside of chloroform, ether, 
and " twilight sleep." 

ANALGESIA VS. ANESTHESIA 

The reader should understand the difference between 
analgesia and anesthesia. Anesthesia refers to the condition 
in which the patient is more or less unconscious — wholly or 
partially oblivious to what is going on, and, of course, entirely 
insensible to all pain. Analgesia is a term applied to the loss 
of pain sensation. The patient may not be wholly or even par- 
tially unconscious — merely under the influence of some agent 
which dulls, deadens, or otherwise destroys the realization of 
pain. This is the condition aimed at by the proper administra- 
tion of any form of " twilight sleep," whether by the scopolamin- 
morphin method, or by the nitrous oxid ("sunrise slumber") 
method. 

Any method of treatment which can more or less destroy the 
pain of labor without in any way interfering with its progress, 
and which in no way complicates its course or leaves behind 
any bad effects on either mother or child, must certainly be 
hailed with joy by both the patient and the physician. While 
chloroform has served these purposes fairly well, there have 



SUNRISE SLUMBER AND NITROUS OXID 87 

been numerous drawbacks and certain dangers; and it was the 
knowledge of these limitations in the use of both chloroform 
and ether, that has led to further experimentation and the 
development of these newer methods of producing satisfactory 
analgesia — freedom from pain — without bringing about such 
a state of profound anesthesia as accompanies the administra- 
tion of the older methods. 

It should be borne in mind that in using " sunrise slumber " 
(nitrous oxid) for labor pains, the gas is so administered that 
the patient is just kept on the " borderline " — in a typical " twi- 
light " state — and not in the condition of deep anesthesia which 
is developed when nitrous oxid is employed by physicians and 
dentists as an anesthetic for major and minor surgical opera- 
tions. 

Analgesia is the first stage of anesthesia — the " twilight 
zone " of approaching unconsciousness — in which the sense 
of pain is greatly dulled or entirely lost, while even that which 
is experienced is not remembered. It seems to the authors that 
"gas" is the ideal drug for producing this condition whenever it 
is necessary, as nitrous oxid is the most volatile of anaesthetics, 
acts most quickly, and its effects pass away most rapidly, while 
its administration is under the most perfect control — it may be 
administered with any desired proportion of oxygen — and may 
be discontinued on a moment's notice. It is practically free 
from danger even when continued as an analgesic for several 
hours. Nitrous oxid never causes any serious disturbance in the 
unborn child, as chloroform sometimes does when used 
too liberally. 

EFFECTS OF NITROUS OXID 

It will not be necessary to compare the favorable and un- 
favorable claims for nitrous oxid as we did the contentions for 
and against " twilight sleep." Whatever service " laughing- 
gas " or " sunrise slumber " can render the cause of obstetrics 
we can accept, knowing full well that, in competent hands, it 
can do little or no harm ; and this we know from the facts here- 
with recited and from the further fact that we have gained a 
wide experience with this agent in the practice of both dentistry 



88 THE MOTHER AND HER CHILD 

and surgery. In a general way, the influence of " sunrise slum- 
ber " on mother and child may be summarized as follows : 

1. It can accomplish its purpose — can quite satisfactorily 
relieve the mother of severe pain — when employed as an 
analgesic. It is not necessary to administer the gas to the point 
of anesthesia except at the height of suffering at the end of the 
second stage of labor, when the head of the child is passing 
through the birth canal. 

2. This method can be stopped at any moment — the patient 
can be brought out from under its influence entirely and almost 
instantaneously. It is not like a hypodermic injection of a drug 
which may exert a varying and unknown influence upon the 
patient, and which, when once given, cannot be recalled. 

3. It is a method which may be used in the patient's home 
just as safely as in a hospital; the only drawback being the 
inconvenience of transporting the gas-containing cylinders back 
and forth. This is even now partially overcome by the improved 
combination gas and oxygen form of apparatus which has been 
devised. 

4. The administration of nitrous oxid analgesia or anesthesia 
does not interfere with or lessen the uterine contractions or 
expulsive efforts on the part of the mother — at least not to 
any appreciable extent. 

5. Just as soon as a severe uterine contraction — attended by 
its severe pain — begins to subside, the gas inhaler is immedi- 
ately removed, and in a few seconds the patient is again 
conscious. It is not necessary to keep the patient continuously 
under the influence of the drug, as in the case of the scopolamin- 
morphin method of " twilight sleep." 

6. This method ("sunrise slumber") is certainly far more 
safe in ordinary and unskilled hands than the " twilight sleep " 
procedure. The patient is more safe with this method in the 
hands of the average doctor or trained nurse. 

7. It has been our experience that nitrous oxid in the smaller, 
interrupted and analgesic doses, actually tends to stimulate the 
uterine pains and contractions, while at the same time rendering 
the patient quite oblivious to their presence. When properly 
administered, the freedom from pain is perfect. 



SUNRISE SLUMBER AND NITROUS OXID 89 

8. Under the influence of " gas," patients often appear to 
" bear down " with increased energy. It certainly does not 
lessen their cooperation in this respect. 

9. We have not observed, nor have we learned of, any cases 
of inertia (weak and delayed contractions), post partum hemor- 
rhage, or shock, as a result of " laughing gas " or " sunrise 
slumber " analgesia. 

10. This method lends itself to perfect control — it may be 
decreased, increased, or discontinued, at will; it may be given 
light now and heavy at another time; while, at the height of 
labor, it may be pushed to the point of complete anesthesia, if 
desired. 

11. We have found "sunrise slumber" (nitrous oxid) anal- 
gesia to be the ideal obstetric anaesthetic, and have adopted it 
quite to the exclusion of both chloroform and " twilight sleep." 
We find that this form of analgesia has all the advantages of 
" twilight sleep " without any of its dangers or disadvantages. 

12. A possible objection to the nitrous-oxid method is the 
cost, especially in the private home. The average cost in the 
hospitals where we are using this method runs about $2.00 for 
the first hour and $1.50 for each hour thereafter. This is the 
cost when using large tanks of gas, and is, of course, somewhat 
increased when the smaller tanks are used in the patient's 
home. 

METHOD OF ADMINISTRATION 

Since it was thought best to give the reader some idea of the 
technic for the administration of " twilight sleep," it may not 
be amiss to explain how " sunrise slumber " is usually employed 
in labor cases. The technic is very simple. The administration 
of the gas is generally begun about the time the patient begins 
seriously to complain of the severity of the second stage pains; 
although, of course, the gas can be given during the first stage 
pains if desired. In the vast majority of cases, however, we 
think it is best to encourage the patient to endure these earlier 
and lighter pains without resorting to analgesic procedures. 

The form of apparatus used is the same as that employed 
by dentists and contains both nitrous oxid and oxygen cylinders. 



9 o THE MOTHER AND HER CHILD 

A small nasal inhaler is best, although the ordinary mouth- 
piece will do very well. The gasbag attached to the tank 
should be kept under low pressure and, as a pain begins, the 
patient is told to breathe quietly, keeping the mouth closed. 
As a rule this sort of light inhalation serves to produce the 
desired analgesic effect. It is not necessary to put the patient 
deeply under in order to relieve the pain. 

It is our custom to begin " sunrise slumber " as soon as the 
uterine contractions become painful. The earlier the gas is 
started, the more oxygen should be used. Two or three in- 
halations will suffice to take the " edge " off the earlier and 
lighter pains. When the pains grow heavier we use less oxygen 
and permit three or four deep inhalations just before a bearing- 
down pain. At the first suggestion of a contraction, the patient 
must begin to inhale the gas ; while after the patient has pulled 
hard on the traction strops — just as the contraction pain is 
passing — she is given an inhalation containing a larger per- 
centage of oxygen. 

At the beginning of a pain, pure nitrous oxid is administered, 
and the patient is instructed to breathe deeply and rapidly 
through the nose. The gasbags should be about half filled. 
The mixture of gas and oxygen must be determined by the 
severity of the pains and individual behavior of the patient. 

Four to six inhalations of the gas are sufficient to produce 
the required analgesia in the average case. Following the first 
few deep inspirations through the nose, the patient can be in- 
structed to breathe through the mouth, while the gas is well 
diluted with oxygen and continued until the end of the pain. 
In this way a satisfactory analgesia is maintained throughout 
the " pain " with a minimum of " gas." The proportion of 
oxygen used will run from nothing up to ten per cent. This 
procedure is repeated with the occurrence of each pain. 

The use of the " mask " is just as effective as a nasal inhaler, 
but wastes more gas and so is more costly. 

When the head is passing the perineum the gas should be 
pushed to the point of anesthesia, while the patient's color will 
suggest the amount of oxygen to be used as well as serve to 
control the administration of the nitrous oxid. 



SUNRISE SLUMBER AND NITROUS OXID 91 

CHLOROFORM AND ETHER 

For many years chloroform and ether have been "used to 
alleviate the pains of women in labor. Valuable as these agents 
are when deep anesthesia is required for the carrying out of 
operative procedures, they have not proved satisfactory as 
analgesic agents. If administered in small quantities at the com- 
mencement of a strong uterine contraction, the patient does not 
usually inhale sufficient to abolish pain. She is then apt to be 
irritated and is certain to insist on being given a larger quantity. 
If a sufficient amount be administered to satisfy the woman, the 
continued repetition gradually inhibits the power both of the 
uterus and of the accessory muscles, so that labor is unneces- 
sarily prolonged, and, possibly, the life of the fetus endangered. 
Physicians have, therefore, been accustomed to employ these 
drugs very sparingly, restricting their use to the very end of 
the second stage, during the painful passage of the head through 
the vulva. The results of the administration at this time are 
also uncertain. If delivery be rapid the woman may not be 
able to inhale sufficient to abolish her consciousness of pain. 
If it be slow she may take too much and weaken the muscular 
powers, thereby prolonging labor and, often, necessitating for- 
ceps delivery. It is not surprising, therefore, that the medical 
profession has long been hoping that a more satisfactory method 
of relieving the pain of labor would be found. 

CONCLUSIONS 

In summing up our conclusions regarding analgesia and anes- 
thesia in labor cases, the authors would state their present posi- 
tion as follows: 

1. That anesthetics or analgesics are a necessary accompani- 
ment of confinement in this day and age; that the average 
labor case demands some sort of pain-relieving agent at some 
time during its progress; but that intelligent efforts should be 
put forth to limit and otherwise control their use. While we 
recognize the necessity for avoiding needless suffering, at the 
same time we must also avoid turning our women into spineless 
weaklings and timid babies. 



92 THE MOTHER AND HER CHILD 

2. That we should seek to develop, strengthen, and train our 
girls for a normal and natural maternity; that we should study 
to attain something of the naturalness and the painlessness of 
the labors of Indian tribes ; and, even if we partially fail in this 
effort, we shall at least leave our women with ennobled char- 
acters and strengthened wills. 

3. That the scopolamin-morphin method of inducing " twilight 
sleep " has its place — in the hands of experts — and in the 
hospital; and that in many cases it probably represents the best 
method of obstetric anesthesia which can be employed. 

4. That as a general rule and in general practice, the safest 
and best method of inducing the " twilight " state of freedom 
from severe pain, is by the use of nitrous oxid or " laughing 
gas " — the " sunrise slumber " method. It has been our prac- 
tice to start all general ether anesthetics with "gas" for a 
number of years, while we have been doing an increasing num- 
ber of both minor and major operations with " gas " alone. 

5. That we still employ general ether or chloroform anes- 
thesia in Cesarean sections and other major obstetric operations, 
although several operators are beginning to use " gas " in even 
these heavy cases. 

6. That the intelligent and careful use of pituitary extract 
in certain cases of labor serves greatly to shorten the second 
stage; that it is of great value in certain "slow cases," and 
serves greatly to reduce the use of low forceps. 

We have treated the subject of obstetric anesthesia in this 
full manner, because of the fact that so much has appeared 
in the public press on these subjects, and, further, because we 
desired that our readers should have placed before them the 
facts on all sides of the question just as fully as a work of 
this scope would permit. 



CHAPTER XI 
THE CONVALESCING MOTHER 

POPULARLY spoken of as the " lying-in period," and 
medically known as the puerperium, this time of conva- 
lescence immediately following childbirth is usually occupied by 
two important things: the restoration of the pelvic organs to 
their normal condition before pregnancy, and the starting of 
that wonderfully adaptative mechanism concerned with the pro- 
duction of the varying and daily changing food supply of the 
offspring. 

The uterus, now more than fifteen times its normal size and 
weight, begins gradually to contract and assume its normal 
weight of about two ounces; and it requires anywhere from 
four to eight weeks to accomplish this involution. In view of 
all this it is obvious that there can be no fixed time to " get up." 
It may be at the end of two weeks, or it may not be until the 
close of four or five weeks, in the case of the mother who cannot 
nurse her child; for the nursing of the breast greatly facili- 
tates the shrinking of the uterus. Extensive lacerations may 
hinder the involution as well as other accidents of childbirth, 
so it must be left with the physician to decide in each individual 
case when the mother may enter into the activities of life and 
assume the responsibilities of the care of the baby and the 
management of her home. 

THE NURSE 

During this period of the puerperium a member of the family, 
a neighbor, a visiting nurse, a practical nurse, or a trained 
nurse, looks after the mother and gives to the babe its first 
care; whoever it may be, certain laws of cleanliness must be 
carried out if infection is to be guarded against. If there are 

93 



94 THE MOTHER AND HER CHILD 

daily or semi-daily calls made by the physician, a member of 
the family may be trained to care for the mother with proper 
cleanliness and asepsis; but it is far better for the mother, if 
possible, to secure the services of a trained nurse, or the visiting 
nurse, in which instance she will call each day, wash and dress 
the baby, clean up the mother and care for the breasts. She is 
not supposed to clean the room, make the bed or prepare the 
food. If a trained nurse can be in charge, the convalescing 
time is usually shortened as the responsibilities are taken from 
the mother, her mind freed from care and it is her's to improve, 
rest, and wait for the restoration of the pelvic organs, when she 
may again go forth among her family. 

The nurse may have to sleep in the same room; but, if it be 
possible, she should occupy an adjoining room, she should have 
a regular time each day for an hour's walk in the fresh air, she 
should be served regular meals, and be allowed some time out 
of the twenty-four hours for unbroken slumber. In return she 
will intelligently cooperate with the physician in bringing about 
the restoration of body and upbuilding of the mother's nerves. 

REST AND EXERCISE 

From a monetary standpoint there can be nothing so wasteful 
or extravagantly expensive in the home as to allow the mother 
to drag about from day to day and week to week with chronic 
weakness or invalidism because she did not have proper care 
during her already too short puerperium, or because she got 
up too soon. 

Having a baby is a perfectly normal, physiological procedure. 
It is also, usually, downright hard work; and, beside the hard 
laborious work, there is not only a wearied and severely shocked 
nervous system to be restored, but there is also a certain amount 
of uterine shrinkage which must take place — and this requires 
from four to eight weeks; and so our mother must be allowed 
weeks or even a month or two to rest, to enjoy a certain amount 
of well-directed exercise, to have an abundance of fresh air, 
to be wheeled or lifted out of doors if possible into the sunshine, 
that she may be the better prepared for the additional duties 
and responsibilities the little new comer entails. Sunshine and 



THE CONVALESCING MOTHER 95 

fresh air are wonderful health restorers as is also a well-directed 
cold water friction bath administered near the close of the 
second week of a normal puerperium. During the second week 
a few carefully selected exercises such as the following are not 
only beneficial, but tend to increase circulation and thus to pro- 
mote the secretion of milk and the shrinking of the uterus. 

1. Head raising, body straight and stiffened. 

2. Arm raising, well extended. 

3. Leg stretching, with knees stretched and toe extended. 

4. Massage, administered by the nurse. 

A splendid tonic circulatory bath may be administered at the 
close of the second week (in normal puerperium), known as the 
" cold mitten friction," which is administered as follows : The 
patient is wrapped in a warm blanket, hot water bottle at feet, 
and each part of the body — first one arm then the other ; the 
chest, the legs, one at a time — is briskly rubbed with a coarse 
mit dipped in ice water. As one part is dried it is warmly 
covered, while the next part is taken, and so on until the entire 
body has been treated. The body is now all aglow, the blood 
tingling through the veins, and the patient refreshed by this 
wide-a-wake bath. Properly given, the cold-mitten friction bath 
is one of the most enjoyable treatments known and under 
ordinary conditions, if intelligently administered, may be given 
as early as the eighth day. 

AFTER PAINS 

After the birth of the first baby the uterus usually is in a 
state of constant contraction, hence there are no " after pains ; " 
but after the birth of the second or third child, the uterine 
muscle has lost some of the tone of earlier days — there is a 
tendency toward relaxation — so that when the uterine muscle 
does make renewed efforts at contraction, these " after pains " 
are produced. They usually disappear by the third day. Noth- 
ing should be done for them, indeed they should be welcomed, 
for their presence means good involution (contraction) of the 
uterus. 



96 THE MOTHER AND HER CHILD 

THE TEMPERATURE 

Careful notations of the temperature should be made during 
the first week. A temperature chart should be accurately kept 
and if the temperature should rise above ioo° the physician 
should be notified at once. The third day temperature is 
watched with expectancy, for if an accidental infection occurred 
at the time of labor, it is usually announced by a chill and 
sudden rise of temperature on the third day. This may be as 
good a place as any to mention the commonly met night sweat- 
ing. This is due to a marked accentuation of the function of 
the skin. It is not at all unusual for a sleeping mother in the 
early puerperium to wake up in a sweat with night gown very 
nearly drenched. The gown should be changed underneath the 
bedding, while alcohol is rubbed over the moistened skin sur- 
face. 

These sweats will disappear as soon as the mother begins to 
regain her strength. A vinegar rub administered on going to 
bed may often prevent these sweats. 

THE TOILET OF THE VULVA 

Immediately after the birth of the baby and the expulsion of 
the afterbirth, the thighs and vulva are cleansed as follows: 
Into a basin of warm, boiled water are dropped four small 
antiseptic tablets of bichlorid of mercury; this gives a proper 
antiseptic wash. Into this solution are placed four pieces of 
sterile cotton. Two of these are used, one at a time, without being 
returned to the solution to wash each inside of the thigh, the 
remaining two to cleanse the vulva. Without drying the vulva, 
two sterile pads are applied and pinned to the binder. These 
pads are changed every hour during the first day or two because 
of the profuse lochial flow. 

After each urination and bowel movement, a lysol solution 
(prepared by putting one teaspoonful of lysol in a quart of 
sterile water) is poured from a clean pitcher over the vulva 
into the bed pan, and fresh pads applied. This toilet continues 
until the close of the second week or longer, if there is a lochial 
flow. 



THE CONVALESCING MOTHER 97 

These sterile pads not only absorb the lochia but also, among 
ignorant or thoughtless mothers, prevent contamination by the 
patient's hands. 

URINATION 

The patient should be encouraged to urinate during the first 
few hours after labor; catheterization should not take place 
until every effort has been made to bring about normal urina- 
tion ; or, until there is a well marked tumor above the bony arch 
of the pelvis in the lower part of the abdomen. It is far less 
harmful to the patient for her to sit up on the jar placed on the 
edge of the bed, than to undergo the risk of inflammation of the 
bladder which so often follows catheterization. 

THE LOCHIA 

The first few days the lochia is very red because of the large 
amount of blood which it contains. After the third or fourth 
day it is paler and after the tenth it assumes a whitish or 
yellowish color. During the three changes it should always 
smell like fresh blood. Any foul, putrifying odor should be 
promptly reported to the physician. 

If on getting up at the close of the second week the lochia 
should resume its red color, the patient should return to bed and 
notify her physician. 

THE ABDOMINAL BINDER 

After the tenth day, the abdominal binder may be pinned as 
tightly as the patient desires, but prior to the tenth day many 
physicians believe the exceedingly tight binder causes mis- 
placements of the enlarged, softened, and boggy uterus. It 
should be pinned snugly ; but not drawn as tight as possible with 
the idea of keeping the uterus from relaxing, for at best, it 
does not do it; while tight constriction may produce a serious 
turning or flexion of the uterus. The breast binder is applied 
during the first twenty-four hours to support the filling breasts, 
loosely at first, and as they increase in size, as the glands 
become engorged, the binder is drawn more tightly. A sterile 
piece of gauze is placed over the nipples. 



98 THE MOTHER AND HER CHILD 

THE BOWELS 

On the morning of the second day a cathartic is usually 
given — say one ounce of castor oil or one-half bottle of citrate 
of magnesia. The bowels should move at least once during each 
twenty- four hours; if they are obstinate, a simple laxative 
may be nightly administered. Certain constipation biscuits, 
sterilized dry bran, or agar-agar may be eaten with the break- 
fast cereal. Prunes and figs should be used abundantly. Bran 
bread should be substituted for white bread. The enema habit 
is a bad one and should not be encouraged ; however, the enema 
is probably less harmful than the laxative-drug habit. Mineral 
oil is useful as a mild laxative, and does not produce any bad 
after results. 

CARE OF THE NIPPLES 

Fissures of the nipples should be reported to the physician at 
once. There are many good remedies which the physician may 
suggest; in his absence, Balsam Peru may be advantageously 
applied. Boracic acid solution should be applied before and 
after each nursing from the very first day; in this way much 
nipple trouble may be prevented through cleanliness and care. 
The nipples should be kept thoroughly dry between nursings. 
Nipple shields should be used where fissures persist. 

THE DIET 

For the first three days a liquid and soft diet is followed 
such as hot or cold milk, gruels, soups, thin cereals, eggnog 
(without whiskey), eggs, cocoa, dry toast, dipped toast, or 
cream toast. There should be three meals with a glass of hot 
milk at five in the morning (if awake) and late at night; noth- 
ing between meals except plenty of good cold water. After the 
third day, if temperature is normal, a semi-solid diet may be 
taken, such as baked, mashed, or creamed potatoes, soups 
thickened with rice, barley or flour, vegetables (peas, corn, 
asparagus, celery, spinach, etc.) ; eggs, light meats, stale breads, 
toast, bland or subacid fruits (sweet apples, prunes, figs, dates, 
pears, etc.) ; macaroni, browned rice (parched before steaming), 
etc.; ice cream, custards, and rice puddings for desserts after 



THE CONVALESCING MOTHER 99 

the seventh day. Three good meals a day, at eight and one 
and six, with a couple of glasses of hot milk or cocoa or an 
eggnog at five a. m., to be repeated at 9 or 10 p. m., with 
plenty of cold water between the meals, will abundantly supply 
the necessary milk for the growing babe. Tea and coffee are 
not of any special value in encouraging a flow of milk. 

The constant coaxing of the mother with " Do drink this," 
and " You must drink this, or you won't have any milk," not 
only saddens her but seriously upsets digestion and thus indi- 
rectly interferes with normal lactation. 

GETTING UP 

Everybody should stay at home and away from the mother 
and her new born child until after the seventh day, and then, 
if our patient is normal, visitors may call, but should not stay 
longer than five minutes. The convalescing mother will improve 
faster without the neighborhood gossip, or the tales of woe so 
often carried by well-meaning, but woefully ignorant acquaint- 
ances. 

When the hard ball-like mass can no longer be felt in the 
lower abdomen, when the lochia has passed through the three 
changes already mentioned, and the flow is whitish or yellowish, 
scanty and odorless, the patient may sit up in a chair increas- 
ingly each day. Such conditions are usually found anywhere 
from the tenth to the fifteenth day. The patient first sits up 
a little in a chair — she has already been exercising some in 
bed — and this enables her to sit up with ease for a half-hour 
the first day, increasing one-half hour each day during the week 
following. At the end of three weeks, she may be taken down 
stairs providing there is ample help to carry her back up stairs. 
After another week (at the close of the fourth), if the lochia 
is entirely white or yellow, with no blood, she may begin care- 
fully to go about the house. There should be no lifting, shoving, 
pulling, wringing, sweeping, washing, ironing, or other heavy 
exercise for at least another two weeks, better four weeks. 
Any variance from this program usually means backache, lassi- 
tude, diminished milk supply, and frequently a general invalid- 
ism for weeks or months — sometimes years. 



ioo THE MOTHER AND HER CHILD 

COMPLICATIONS 

Cystitis, or painful urination, is avoided by tardy " getting 
up;" quietly, slowly moving about; abundant water drinking; 
and the avoidance of catheterization. 

Hemorrhage. Notify the physician if it occurs at any time. 
The treatment is heavy kneading of the abdomen until the uterus 
again becomes like a hard ball. Cold compresses over the lower 
abdomen may sometimes help. 

Infection is manifested by chilly sensations or a distinct chill 
followed by fever, usually on the third day. Take a cathartic; 
notify the physician at once and follow his directions. 

Mastitis, inflammation or caking of the breasts. Very hot 
fomentations wrung out of boiling water, alternating with ice- 
cold compress, should be applied to the breast for an hour 
or more, three or four times a day. Cathartics should be 
administered, and eliminative measures instituted such as the 
hot-blanket pack. 

Pneumonia. Keeping the arms and chest well protected by a 
long-sleeved coat of warm texture, should help in preventing 
this serious complication. Pneumonia complicating labor is 
usually the result of carelessness and exposure. 



PART II 
THE BABY 



PART II 
THE BABY 



CHAPTER XII 
BABY'S EARLY DAYS 

HAPPY is the mother and fortunate is the home that pos- 
sesses the intelligent services of a trained attendant during 
the early days of the baby's career. A century or more ago 
skilled nurses were unheard of, >and both mothers and babies 
seemed to thrive on the unskilled but faithful and sympathetic 
care given by the willing neighbor who " thought I'd just run 
over and help out." Who of us cannot remember the days 
when mother was " gone to a neighbor's " to give this same will- 
ing but unskilled care at the time of " confinement." 

MODERN METHODS 

And why are we so concerned today about asepsis, steriliza- 
tion, etc., when a generation ago they were not? We used to 
live more slowly than we do now. Then it took the entire day 
to do the marketing for the week, now we take a receiver from 
the hook and a telephone wire transmits the verbal message. 
Our days are literally congested with events that were almost 
impossibilities a century ago. The ease and leisure of former 
days are unknown and unheard of today. The artificial way in 
which we live exerts more or less of a strain upon the present 
generation; the average woman's nervous system is keyed up 
to a high pitch; her general vital resistance is running at a 
low ebb; while child-bearing brings a certain added stress and 
strain that requires much planning to avoid and overcome. 

For many days and ofttimes weeks the mother is unfit — 
physically unable — properly to care for her child, and so 

103 



104 THE MOTHER AND HER CHILD 

whether it be the trained assistant in constant attendance or the 
visiting nurse in her daily calls, or the kind, willing, but unskilled 
neighbor — each helper must acquaint herself, in varying de- 
grees, with the physical, nervous, and mental needs of the 
child, as well as take into account and anticipate the numerous 
habits and wants of the new born babe, such as urination, bowel 
movement, pulse, respiration, temperature, etc. 

THE HEAD 

At birth, the head is remarkably large as compared to the 
rest of the body, for, surprising as it may seem, the distance 
from the crown to the chin is equal to the length of the baby's 
trunk; and, too, if birth has been prolonged this large head has 
also been pressed or squeezed somewhat out of shape. This 
state of affairs, however, need give no cause for either alarm 
or anxiety, for the head will shape itself to the beautiful rotund- 
ity of the normal baby's head within, a few days. 

The general shape of the baby's head, as seen from above is 
oval. Just back of the forehead is formed a diamond-shaped 
soft spot known as the anterior fontanelle which should measure 
a little more than one inch from side to side. On a line just 
posterior to this soft spot and to the back of the head, is 
found another soft spot somewhat smaller than the one in front. 
Gradual closure of these openings in the bones occurs, until at 
the end of six or eight months, the posterior fontanelle is 
entirely closed; while eighteen months are required for the 
closure of the anterior fontanelle. 

These " soft spots " should not be depressed neither should 
they bulge. The head is usually covered with a growth of soft, 
silky hair which will soon drop out, to be replaced, however, by 
a crop of coarser hair in due season. The scalp should always 
be perfectly smooth. Any rash or crusts or accumulation of 
any kind on the scalp is due to uncleanliness and neglect, and 
should be carefully removed by the thorough application of 
vaseline followed by a soap wash. The vaseline should be 
applied daily until all signs of the accumulation are entirely 
removed. The eyes of all babies are generally varying tints 
of blue, but usually change to a lighter or darker hue by the 



BABY'S EARLY DAYS 105 

seventh or eighth week. The whitish fur which often is seen 

on the baby's tongue is the result of a dry condition of the 

mouth which disappears as soon as the saliva becomes more 
abundant. 

CHEST, ABDOMEN, AND LEGS 

The baby's chest, as compared to the size of the head and 
abdomen, appears at a disadvantage, while the arms are com- 
paratively short and the legs particularly so, since they measure 
about the same as the length of the trunk. They naturally 
" bow in " at birth so that the soles of the feet turn decidedly 
toward each other. All these apparent deformities, as a rule, 
right themselves without any help or attention whatsoever. 

PULSE AND RESPIRATION 

The pulse may be watched at the anterior fontanelle or soft 
spot on top of the head while the child quietly sleeps and should 
record, at varying ages, as follows: 

At birth 130 to 150 

First month 120 to 140 

One to six months about 130 

Six months to one year about 120 

One to two years no to 120 

Two to four years 90 to no 

The above table is correct for the inactive normal child. 
Muscular activity, such as crying and sucking, increases the 
pulse rate from 10 to 20 beats per minute. 

The respiration of the baby often gives us no small amount 
of real concern at the first. The baby may be limp and breath- 
less for some few moments at birth, and this condition calls 
for quick action on the part of the nurse and doctor. 

The utmost care to avoid the " sucking in " of any liquid 
or blood during its birth must be exercised, for this often 
seriously interferes with the breathing. Sometimes this condi- 
tion is not relieved until a soft rubber catheter is placed in the 
throat and the mucus is removed by quick suction. When you 
are reasonably sure that there is no more mucus in the throat, 



106 THE MOTHER AND HER CHILD 

then sudden blowing into the baby's lungs (its lips closely in 
touch with the lips of the nurse or physician) often starts 
respiration. Slapping it on the back also helps, while the quick 
dip into first hot then cold water seldom fails to give relief. 

A quiet-sleeping infant breathes as shown below at varying 
ages. An increase of six to ten breaths per minute may be 
allowed for the time it is awake or otherwise active. 

At birth and for the first two or three weeks. .30 to 50 

During the rest of the first year 25 to 35 

One to two years about 28 

Two to four years about 25 

THE WEIGHT 

The normal weight of the average baby is seven to seven and 
one-half pounds. Its length may range anywhere from sixteen 
to twenty-two inches. 

There is an initial loss of weight during the first few days; 
however, after the milk has been established the child should 
make a weekly gain of four to eight ounces until it is six 
months old, after which time the usual gain is from two to 
four ounces per week. 

If the weight has been doubled at six months and the weight 
at one year is three times the birth weight, the child is said to 
have gained evenly and normally. 

THE SKIN 

At birth the skin of the baby is red and very soft owing to 
the presence of a coating of fine down. A blue-tinged skin 
may be occasioned by unnecessary exposure or it may be due 
to an opening in the middle partition of the heart which should 
close at birth. As soon as the baby is born, it should be placed 
on its right side while the cord is being tied, as this position 
facilitates closure of this embryonic heart opening. With the 
provision for a little additional heat the blue color should 
disappear, if it is not due to this heart condition. At the close 
of the first week the red color of the skin changes to a yellow 
tint due to the presence of a small amount of bile in the blood. 
This sort of jaundice is very common and is in no wise evidence 



BABY'S EARLY DAYS 107 

of disease. The " down " falls off with the peeling of the skin 
which takes place during the second week ; by the end of which 
time, the skin is smooth and assumes that delightful " baby " 
character so much admired. 

THE CORD DRESSING 

The cut end of the tied umbilical cord is swabbed and 
squeezed with a sterile sponge saturated with pure alcohol. It 
is then wrapped in a sterile dressing made as follows : Four or 
five thicknesses of sterile cheese cloth are cut into a four-inch 
square with a small hole cut in the center and one side cut to 
this center. This is slipped about the stump of the cord and 
wrapped around and about in such a manner as entirely to 
cover the stump of the cord. The wool binder is then applied 
and sewed on, thus avoiding both pressure and the prick of 
pins. If it remains dry this dressing is not disturbed until the 
seventh or eighth day, when the cord ordinarily drops off. 
Should it become moistened the dressing is removed and the 
second dressing is applied exactly like the first. 

THE EYES 

The closed eyes of the newly born child are generally cov- 
ered with mucus which should be carefully wiped off with a 
piece of sterile cotton dipped in boracic acid solution, in a 
manner not to disturb the closed lid. A separate piece of cotton 
is used for each eye and the swabbing is done from the nose 
outward. The physician or nurse drops into each opened eye 
two drops of twenty per cent argyrol, the surplus medicine 
being carefully wiped off with a separate piece of cotton for 
each eye. The baby should now be placed in a darkened 
corner of the room, protected from the cold. 

The eyes are washed daily by dropping saturated solution 
of boracic acid into each eye with a medicine dropper. Separate 
pieces of gauze or cotton are used for each eye. 

THE FIRST OIL BATH 

As soon as the cord and the eyes have received the proper 
attention and the mother has been made comfortable, the baby 



108 THE MOTHER AND HER CHILD 

is given its initial bath of oil. This oil may be lard, olive oil, 
sweet oil, or liquid vaseline. The oil should be warmed and the 
baby should be well covered with a warm blanket and placed on 
a table which is covered with a thick pad or pillow. The temper- 
ature of the room should be at least eighty degrees Fahrenheit. 
Quickly, thoroughly, and carefully the entire body is swabbed 
with the warmed oil ■ — the head, neck, behind the ears, under 
the arms, the groin, the folds of the elbow and knee — no part 
of the body is left untouched, save the cord with its dressing. 
This oil is then all gently rubbed off with an old soft linen 
towel. 

THE FIRST CLOTHING 

After the oil bath, the silk and wool shirt (size No. 2), the 
diaper and stockings are quickly put on to avoid the least 
danger of chilling. The band having been applied at the time 
of the dressing of the cord, our baby is now ready for the 
flannel skirt. This should hang from the shoulders by a yoke 
of material adapted to the season, cotton yoke without sleeves 
if a summer baby, and a woolen yoke with woolen sleeves if 
a winter baby. The outing-flannel night dress completes the 
outfit and should be the only style of dress worn for the first 
two weeks. Loosely wrapped in a warm shawl, the baby is 
about ready for its first nap, save for a drink of cooled, boiled 
water. 

This cooled, boiled, unsweetened water should be given in 
increasing amounts every two hours until the child is two or 
three years of age. It is usually given the child in a nursing 
bottle. In this way it is taken comfortably, slowly, can be kept 
clean and warm, and should the babe be robbed of its natural 
food and transferred to the bottle as a substitute for mother's 
milk, it will already be acquainted with the bottle and thus 
one-half of a hard battle has already been fought and won. 

baby's first nap 

The baby's bed should be separate and apart from the 
mother's. It may be a well-padded box, a dresser drawer, a 
clothes basket, or a large market basket. A folded comfortable 



BABY'S EARLY DAYS 109 

slipped in a pillow slip makes a good mattress. A most ideal 
bed may be made out of a clothes basket; the mattress or pad 
should come up to within two or three inches of the top, so the 
baby may breathe good fresh air and not the stale air that is 
always found in a deeply made bed. Into this individual bed 
the baby is placed as soon as it is dressed, and a good sleep of 
four to six hours usually follows. 

Frequent observations of the cord dressing should be made 
as occasionally hemorrhage does take place, much to the detri- 
ment of the babe. If bleeding is at any time discovered the cord 
is retied just below the original tying. By the time baby has 
finished a six- or eight-hour nap the mother is wondrously 
refreshed and is ready to receive it to her breast. 

PUTTING TO THE BREAST 

During the first two days the baby draws from the breasts 
little more than a sweetened watery fluid known as the colos- 
trum; but its intake is essential to the child in that it acts as 
a good laxative which causes the emptying of the alimentary 
tract of the dark, tarry appearing stools known as the meconium. 
On the third day this form of stool disappears and there fol- 
lows a soft, yellow stool two or three times a day. 

The child should be put to the breast regularly every four 
hours; two things being thus encouraged: an abundant supply 
of milk on the third day and the early shrinking of the uterus. 
More than once a mother has missed the blessed privilege of 
suckling her child because some thoughtless person told her 
" why trouble yourself with nursing the baby every four hours, 
there's nothing there, wait until the third day;" and so when 
the third day came, there was little more than a mere sugges- 
tion of a scanty flow of milk, which steadily grew less and less. 

THE URINE 

The urine of the very young child should be clear, free from 
odor and should not stain the diaper, nor should it irritate the 
skin of the babe. Often urination does not take place for sev- 
eral hours, sometimes not at all during the first twenty-four 
hours. If the infant does not show signs of distress, there is 



no THE MOTHER AND HER CHILD 

no cause for alarm; the urine should pass, however, within 
thirty hours. As a rule there are usually between ten and 
twenty wet diapers during each twenty-four hours. The fol- 
lowing table shows about the amounts of urine at different ages : 

Birth to two years 8 to 12 ounces 

Two to five years 15 to 25 ounces 

Five to ten years 25 to 35 ounces 

GENITALS OF THE MALE CHILD 

The foreskin of the male child is often long, tight, and 
adherent, and is often the direct cause of irritability, nervous- 
ness, crying, and too frequent urination. It should be closely 
examined by both physician and nurse and when the foreskin 
does not readily slip back over the acorn-like head of the 
organ, circumcision is advised early in the second week. This 
simple operation will start the child out on his career with 
at least one moral handicap removed and one desirable pos- 
sibility established — that of being able to keep himself clean. 

POST-OPERATIVE CARE OF CIRCUMCISION 

The dressings that are loosely applied at the time of the 
operation should remain untouched (especially those next to 
the skin), unless otherwise directed by the physician, until the 
seventh or eighth day when the babe is placed in a warm soap 
bath, at which time the dressings all come off together. Clean 
sterile gauze is so placed as entirely to protect the inflamed 
skin from the diaper at all times before this bath, and these 
same dressings should be continued for at least another week. 
Sterile vaseline (from a tube) should be applied twice a day 
after the original dressings are removed in the bath at the end 
of the first week. There should be little or no bleeding follow- 
ing the operation, neither should the penis swell markedly; if 
either complication should occur, the physician should be 
promptly notified. 

CARE OF THE FEMALE GENITALS 

The girl baby is often neglected in respect to the proper care 
of the genitals. The lips of the vulva should be separated and 




Fig. 6. How to Hold the Baby 



BABY'S EARLY DAYS ill 

thorough but careful cleaning should be the daily routine. The 
foreskin or covering of the clitoris should not be adherent; 
while the presence of mucus, pus, or blood in the vulva should 
be at once reported to the physician; in his absence, the appli- 
cation of twenty per cent argyrol should be made daily. 

HANDLING THE BABY 

Let us thoroughly come to understand the very first day 
the little one's life, that it was not sent to us because the family 
needed something to play with; it is not a ball to toss up, 
neither is it a variety show. It is a tiny individual, and your 
responsibilities as parents and caretakers are very great. The 
child was sent to be fed, clothed, kept warm, dry, and other- 
wise cared for by you, until such a time as it will become able to 
care for itself. Remember, what we sow, that shall we also reap. 
If we sow indulgence we shall reap anger, selfishness, irri- 
tability, " unbecomingness " — the spoiled child. At two or 
three days the baby learns that when it opens its mouth and 
emits a holler, someone immediately comes. If we do it on the 
second and third day, why should we object to run, bow, and 
indulge on the one hundredth and second day? 

Handle the baby as little as possible. Turn occasionally from 
side to side, feed it, change it, keep it warm, and let it alone; 
crying is absolutely essential to the development of good strong 
lungs. A baby should cry vigorously several times each day. 
If the baby is to be handled, support the back carefully (Fig. 6). 

THE EARLY BATHS 

During the first week the baby is oiled daily over his entire 
body, with the exception that the cord dressing remains un- 
touched. The face, hands, and buttocks are washed in warm 
water. After the third week the bathroom is thoroughly 
warmed and the small tub is filled with water at temperature of 
ioo F. The baby having been stripped and wrapped in a warm 
turkish towel, is placed on a table protected by a pillow, while 
the caretaker stands by and vaselines the creases of the neck, 
armpits, folds of the elbows, knees, thighs, wrists, and genitals ; 
and then, with her own hands, she applies soap suds all over 



H2 THE MOTHER AND HER CHILD 

the body — every portion of which is more quickly and readily 
reached — than by the use of a wash cloth. And now, with 
the bath at ioo F., with a folded towel on the bottom of the 
small tub, the soapy child is placed into the water and after 
a thorough rinsing is lifted out again to a warm fresh towel 
on the table and the careful drying is quickly begun. After 
the bath all the folds and creases are given a light dusting with 
a good talcum. 

During hot weather the bath should be given daily, soap 
being used twice a week. On the other days there should be the 
simple dipping of the child into the tub. During the cold 
weather the full bath is given but twice a week, while on the 
other days a sponge bath or an oil rub may be administered. 

A weak, delicate child should not be exposed to the daily 
full bath, but rather the semi-weekly sponge bath and the daily 
oil rub should be administered. We have found the late after- 
noon hour to be better than the early morning hour for baby's 
bath. It requires too much vital resistance to react to an early 
morning bath, especially when the house is cool. 

REGARDING SOAP 

The use of soap is very much abused with young babies. 
I recall one mother who came into the office with her poor 
little baby which was constantly crying and fretting because of 
a greatly inflamed body — all a result of the too frequent use 
of soap. I said, " I am afraid you do not keep your baby clean." 
" O Doctor ! " she replied, " I wash him with soap every time 
I change him; I am sure he is clean." And come to find out, 
the poor little fellow's tender skin had been subjected to soap 
several times a day. We ordered the use of all soap discon- 
tinued, vaseline and talcum powder to be used instead, and the 
child's skin got well in a very short time. 

CARE OF THE UMBILICUS 

Tight bands should not be placed about the babe. If the 
umbilicus protrudes, do not endeavor to hold it in by a tight 
band, but consult your physician about the use of a bit of folded 
cotton and adhesive plaster, and then allow the child the free- 



BABY'S EARLY DAYS 113 

dom of the knitted bands, with skirts suspended from yokes. 
The day of tight bands and pinning blankets with their 
additional and traditional windings is over. After the complete 
healing of the cord, the need for a snug binder to hold the 
dressings in place is over. Should the baby cry violently, 
the umbilicus should be protected in the manner described above 
— the fold of cotton and the adhesive plaster. 

The diaper, stockings, shirt, skirt, and dress with an addi- 
tional wrapper for cold days completes the outfit at this age. 

BIRTH REGISTRATION 

" One of the most important services to render the newborn 
baby is to have his birth promptly and properly registered." 

In most states the attending physician or midwife is required 
by law to report the birth to the proper authority, who will see 
that the child's name, the date of his birth, and other particulars 
are made a matter of public record. Birth registration may be 
of the greatest importance when the child is older, and parents 
should make sure this duty is not neglected. 

A public health official some time ago epitomized some of the 
uses of birth registration as follows: 

There is hardly a relation in life from the cradle to the grave in 
which such a record may not prove to be of the greatest value. For 
example, in the matter of descent ; in the relations of wards and 
guardians; in the disabilities of minors; in the administration of 
estates ; the settlement of insurance and pensions ; the requirements 
of foreign countries in matters of residence, marriage, and legacies; 
in marriage in our own country; in voting and in jury and militia 
service; in the right to admission and practice in the professions 
and many public offices; in the enforcement of laws relating to 
education and to child labor, as well as to various matters in the 
criminal code; the irresponsibility of children under ten for crime 
or misdemeanor; the determination of the age of consent, etc., etc. 



CHAPTER XIII 
THE NURSERY 

WE wish it were possible for every mother who reads this 
book to have a special baby's room or nursery. Some of 
our readers have a separate nursery-room for the little folks, 
and so we will devote a portion of this chapter to the description 
of what seems to us a model arrangement for such a room; 
but, realizing that ninety-five per cent of our readers can only 
devote a corner of their own bedroom to the oncoming citizen, 
we have also carefully sought to meet their needs and help 
them to take what they have and make it just as near like the 
ideal nursery as possible. 

THE SEPARATE NURSERY 

The nursery should be a quiet room with a south or south- 
westerly exposure. The bathroom should adjoin or at least be 
near. A screened-in porch is very desirable. 

Draperies that cannot be washed, and upholstered furniture, 
do not belong in the baby's room. A hardwood floor is better 
than a carpet or matting; while a few light-weight rugs, easily 
cleaned, are advisable. Enameled walls are easily washed and 
are, therefore, preferable to wall paper or other dressings. 

The windows should be well screened, for by far the greatest 
dangers to which the baby is exposed, are flies and mosquitoes 
— carriers of filth and disease. Flies, mosquitoes, cockroaches, 
bed bugs, cats, dogs, lice, and mice are all disease carriers and 
must therefore be kept out of baby's room. 

NURSERY EQUIPMENT 

At each window should be found dark shades, and if curtains 
are desired they should be of an easily washable material, such 

114 



THE NURSERY 115 

as mull, swiss, lawn, voile, or scrim. The hardwood floor may 
be covered where necessary with easily handled rugs which 
should be aired daily. The other necessary articles of furniture 
are a crib of enameled iron whose bedding will be described 
elsewhere in this chapter, a chest for baby's clothes and other 
necessary supplies, a screen or two, a low table and a low- 
rocker, a small clothes rack on which to air the clothes at 
night, a pair of scales, and a medicine chest placed high on the 
wall. 

If the room will conveniently admit it, a couch will add 
greatly to the mother's comfort; and, if possible, it should be 
of leather upholstery; otherwise, it should possess a washable 
cover, for all articles that promote the accumulation of dust are 
not to be allowed in the nursery. In these early weeks and 
months baby will not benefit from pictures or other wall decora- 
tions, and so let him have clean walls that are easily washed 
and quickly dusted. 

The necessities for baby's personal care are: 

Talcum powder. Sterile cotton balls in covered 

Castile soap. glass jar. 

Soft wash cloths. Safety pins of different sizes. 

Soft linen towels. Hot water bag with flannel 

Bottle of plain vaseline. cover. 

Boracic acid, oz. iv (Saturated Baby scales. 

Solution). Drying frames for shirt and 

Olive oil. stockings. 

baby's bed 

Since the days of Solomon, accidents have occurred where 
mother and babe have occupied the same bed. Not only is there 
the ever-present danger of smothering the babe, but there are 
also many other reasons why a baby should have its own bed. 
The constant tendency to nurse it too often and the possibility 
of the bed clothing shutting off the fresh air supply, are in and 
of themselves sufficient reasons for having a separate bed for 
baby. 

The first bed is usually a basinet — a wicker basket with high 
sides — with or without a hood. A suitable washable lining 



n6 THE MOTHER AND HER CHILD 

and outside drape present a neat as well as sanitary appearance. 
The mattress of the basinet is usually a folded clean comfort 
slipped into a pillow slip; this is to be preferred to a feather 
pillow, as it is cooler and in every way better for the babe. 

Drapes about the head of the basinet are not only often in 
the way, shutting out air, etc., but they also gather dust and 
are unsanitary. Screens are movable — they may be used or 
put away at will — and are, therefore, very convenient about 
the nursery. 

The basinet may be dispensed with entirely if the sides of the 
enameled crib are lined to cut off draughts and the babe is 
properly supported by pillows. After the baby is four to six 
months of age it is transferred to the crib. The basinet has an 
advantage over the crib during those early weeks in that its 
high sides protect the babe from draughts, and the comforts and 
blankets can be more easily tucked about the little fellow to 
keep him warm. The sides should not extend more than four 
inches above the lying position of the child. 

THE CRIB 

The enameled iron crib should be provided with a woven-wire 
mattress, over which is placed a mattress; hair is best as a 
filling for the mattress, wool next, and cotton last. Over the 
mattress should be placed a rubber sheet, and over all a folded 
sheet. 

A pillow of hair or down is not to be discarded; for recent 
investigation has shown that the pillow favors nasal drainage, 
while lying flat encourages the retaining of mucus in the nose 
and nasal chambers — the sinuses. The pillow slip should be of 
linen texture. 

During the winter a folded soft blanket over the rubber 
sheet increases both softness and warmth. No top sheet is used 
during the first months, particularly if the first months are the 
winter months. The baby is wrapped loosely in a light weight 
clean blanket or shawl, and other blankets — as many as the 
season demands are tucked about the child. These blankets 
should be aired daily, and the one next to the baby changed, 
aired, or washed very often. 



THE NURSERY 



117 




Fig. 7. Making the Sleeping Blanket 



n8 THE MOTHER AND HER CHILD 

THE SLEEPING BLANKET 

To prevent baby from becoming uncovered the sleeping 
blanket has been devised. The blanket is folded and stitched 
in such a way as completely to envelop the sleeping babe, and 
at the same time afford the utmost freedom (Fig. 7). The 
babe may turn as often as he desires, but cannot possibly 
uncover himself. Bed clothes fasteners are also used — an 
elastic tape being securely fastened to the head posts and 
then by means of clamps or safety pins attachment is made to 
the blankets on either side. The elasticity allows considerable 
freedom to the child in turning (See Fig. 8). 

NURSERY HEATING AND VENTILATION 

The subject of ventilation has been so fully discussed by the 
authors in another work that we refer the reader to The Science 
of Living, or the Art of Keeping Well. 

For the first two or three weeks the nursery temperature 
should be maintained at seventy degrees Fahrenheit by day 
and from sixty degrees to sixty-five degrees by night. In the 
third week the day temperature should be sixty-eight degrees 
Fahrenheit measured by a thermometer hanging three feet 
from the floor. After three months the night temperature may 
go as low as fifty-five degrees Fahrenheit, and after the first 
year it may go as low as forty-five degrees. 

The heating of the nursery is usually controlled by the gen- 
eral heating plant, and no matter what system of heating is 
maintained, humidifiers must be used, the necessity for which 
is doubled when the system is that of the hot-air furnace. 

These shallow pans of water with large wick evaporating 
surfaces will evaporate from three to four quarts during the 
twenty-four hours. The humidity should be fifty throughout 
the seasons of artificial heating. 

Many colds may be entirely avoided by the use of humidifiers 
or evaporators. The open grate is one of the very best means 
of nursery heating. Gas and oil heaters should not be depended 
upon for nursery heat. Only in an emergency should they be 
used at all, and the electric heater is by far the best device 
for such occasions. 




Fig. 8. In the Sleeping Blanket 



THE NURSERY 119 

baby's corner in mother's room 
It is probably a conservative estimate to say that ninety-five 
per cent of all the babies occupy a corner of mother's and 
father's bedroom for the first two or three years. And believ- 
ing this estimate to be correct, it is advisable to give the matter 
some consideration. To begin with, a lot of the non-essentials, 
ruffles and fluffles of the average bedroom, must go. The good 
father's chiffonier may have to be put in the bath room; heavy 
floor coverings must be discarded, to be replaced by one or two 
small, light-weight rugs; wall decorations and the usual bric-a- 
brac of dressers, tables, etc., should be carefully packed away. 
In fact, there should be nothing in the room save the parents' 
bed, dresser (several drawers of which must be devoted to 
baby's necessities), table, low rocker, a stool, baby's bed and a 
good big generous screen, made out of a large clothes horse 
enameled white and filled with washable Swiss. 

Window draperies must be taken down and packed away, while 
they are replaced with simple muslin which can go to the 
laundry twice a month. If it be within the means of the family 
purse, it is well to renovate the walls just prior to the advent 
of the little stranger. 

And now the baby's bed is placed in the corner most pro- 
tected from draughts and the glare of the sunlight. If it can 
be so arranged that baby looks away from the light, and not at 
it, we are guarding it from defective vision in the future. 

crib substitutes 

Many a beautiful artistic creation so much admired in this 
world is found to be, on closer inspection, a very ordinary thing 
whicfi has received an artistic touch; and so, many convenient, 
sanitary, and beautiful cribs are fashioned from market baskets 
fastened to tops of small tables whose legs are sawed off a 
bit; from soap boxes fastened to a frame, and from clothes 
baskets. A can of white enamel, a paint brush and the deft 
hand of a merry, cheery-hearted expectant mother can work 
almost miracles. Remember, please, that all draperies must be 
washable and attached with thumb tacks so as to admit of 
easy and frequent visits to the laundry. 



120 THE MOTHER AND HER CHILD 

A medium-sized clothes basket will take care of our baby 
for four or five months. The same general plan for the mat- 
tress and bedding is followed as before described. 

EXTRA HEAT TO THE CRIB 

If necessary — and it usually is, especially during the winter 
months — a hot-water bottle may be placed underneath the 
bedding on top of the mattress. This insures a steady, mild, 
uniform warmth and it not only saves the baby from the danger 
of being burned, but it also obviates the temporary overheating 
of the child which usually occurs when the bottle is placed 
inside the bed, next to the baby. If the bed is properly made 
— the blankets coming from under the babe up and over — 
there is little or no need for extra heat for well babies after 
the first month. 

LIGHTING BABY'S ROOM 

If electric lighting is not an equipment of the home neither 
gas or oil lamps should be allowed to burn in the room for 
long periods. For emergency night lighting a well-protected 
wax candle should be used. However, don't go to sleep and 
allow a candle to burn unprotected as did one tired, exhausted 
mother. The father, suddenly aroused from his sleep, saw a 
large flame caused by the overturning of a wax candle into 
a box of candles, while the lace drapery of the basinet was within 
a few inches of the flame and the baby just beyond. Grabbing a 
pillow he smothered the flames and saved baby and all. 

FRESH AIR 

Plenty of fresh air and lots of sunshine should enter baby's 
room. The large screen amply shields from draughts, and when 
thus protected there need be no unnecessary concern about 
cool fresh air, especially after two or three months, as it is 
invigorating and prevents " catching cold." Warm, stuffy air 
is devitalizing and even during the early weeks when the 
fresh air must be warm, an electric fan should be advantageously 
placed so that many times each day the warm fresh air may 
be put in motion without creating a harmful draught. 



THE NURSERY 121 

Warm stuffy air makes babies liable to catch cold when taken 
out into the open. 

Throw open the windows several times each day and com- 
pletely change the air of baby's room. In the absence of the 
large screen, a wooden board five or six inches high is fitted 
into the opening made by raising the lower window sash. Then 
as the upper sash is lowered the impure air readily escapes while 
fresh air is admitted. 

THE BATH EQUIPMENT 

Make early preparations for bathing the baby in the easiest 
possible manner ; in fact, the young mother should seek to attend 
to all her duties — the family, the home, and the baby — in the 
easiest way. For the administration of a bath during the 
early months, a table is needed, protected by oilcloth on which 
is placed a roomy bathtub with a folded turkish towel on the 
bottom for baby to sit on. In addition to the tub, have : 

An enameled pitcher for extra A medicine dropper for washing 

supply of warm water. baby's eyes. 

A small cup for boracic acid Talcum powder. 

solution. Oil or vaseline. 

Castile soap. Sterile cotton. 

A soft wash cloth. Tooth picks. 

Several warmed soft towels. A needle and thread for sewing 

A bath thermometer. on the band. 

All of the clean clothing needed. 

See that the bathtub is clean and enamel unbroken, and if 
it has been used by another babe, freshen it with a coat of 
special enamel sold for that purpose. 

BATH TEMPERATURES 

During the first eight weeks Temperature 100 F. 

From two to six months Temperature 98 F. 

From six to twenty-four months 

Temperature 90 — 97 F. 

A bath at ninety-eight degrees is a neutral bath, and after the 
baby is six months and over, the bath may be given at this tem- 
perature, and at the close quickly cooled to ninety degrees. 



122 THE MOTHER AND HER CHILD 

NURSERY CLEANLINESS 

The nursery should furnish the baby's first protection from 
contagious diseases. It must be a veritable haven of safety. There- 
fore, no house work of any kind should be done in the room, such 
as washing or drying the baby's clothes. The floors and the fur- 
niture should be wiped daily with damp cloths. A dry cloth or 
feather duster should never be used to scatter dust around the room. 

All bedding and rugs should receive their daily shaking and 
airing out of doors, remembering that particles of dust are 
veritable airships for the transportation of germs. In every 
way possible avoid raising a dust. So much of the lint which 
commonly comes from blankets may be avoided with the 
daily shaking out of doors. 

Soiled diapers should not accumulate in a corner or on the 
radiator; their removal should be immediate, and if they must 
await a more opportune time, soak them in a receptacle filled 
with cold water. Even those diapers slightly wetted should 
never be merely dried and used again, but should be properly 
washed and dried. No washing soda should be used in the 
cleansing of diapers — just an ordinary white soap, a good boil, 
and plenty of rinse water, with drying in the sun if possible. 
They require no ironing. Hands that come in contact with 
soiled or wet diapers must be thoroughly cleansed before caring 
for the baby or preparing his food. 

As before mentioned, and it will bear repetition often, all 
windows and doors must be well screened, for flies and mos- 
quitoes are dreaded foes in any community and in babyland in 
particular. All used bottles and nipples as well as used cups, 
pitchers, bits of used cotton, should be removed at once. The 
washcloth is a splendid harbinger of germs. There should be 
one for the face, and one for the body and bath, and both 
should receive tri-weekly boiling. Bath towels should not be 
used more than twice, better only once. 

The technic of bathing, together with the location, furnish- 
ings, and cleanliness of the baby's sick room, will be taken up 
in later chapters. 



CHAPTER XIV 
WHY BABIES CRY 

IT is surprising how soon even a young and inexperienced 
mother will learn to distinguish between the pain cry and 
the plain cry of her baby; for most crying can easily be traced 
to some physical discomfort which can be relieved, or to some 
phase of spoiling and indulgence which can be stopped. 

NORMAL HEALTHY CRYING 

The young baby can neither walk, talk nor engage in gym- 
nastics, except to indulge in those splendid physical exercises 
connected with a good hearty cry. To be good and healthy, 
an aggregate of an hour a day should be spent in loud and 
lusty crying. He should be allowed to kick, throw his arms 
in the air and get red in the face; for such gymnastics expand 
the lungs, increase general circulation and promote the general 
well-being of the normal child. As the child grows older and 
is able to engage in muscular efforts of various sorts, these 
" crying exercises " should naturally decrease in frequency 
and severity. When baby cries, see that the abdominal band 
is properly applied, that rupture need not be feared. 

THE BIRTH CRY 

The sound most welcomed by both doctor and nurse is the 
cry of the newly born child, for it shows that the inactive lungs 
have opened up and the baby has begun to use them, for all 
the time baby was living in the uterine room he did not 
breathe once, the lungs having been in a constant state of 
collapse; and not until now, the very moment the air comes 
in contact with his skin, do the lungs begin to functionate as 
he emits his first lusty holler. 

123 



124 THE MOTHER AND HER CHILD 

ABNORMAL CRYING 

The cry is said to be abnormal when it continues too long 
or occurs too often. It may be strong and continuous, quieting- 
down when he is approached or taken up ; or it may be a worry- 
ing, fretful cry, a low moan or a feeble whine. And now as 
we take up the several cries, their description, cause, and 
treatment, we desire to say to the young mother: Do not 
yourself begin to fret and worry about deciding just which 
class your baby's cry belongs to ; for help, knowledge, and wis- 
dom come to every anxious mother who desires to learn and 
who is willing to be taught by observation and experience. 

THE HUNGER CRY 

The continuous, fretful cry, accompanied by vigorous suck- 
ing of the fists, both of which stop when hunger has been 
satisfied, is without question the hunger cry. 

If this cry is constant with regular feedings, then the quan- 
tity of the food must be increased, or the quality improved. 
The tired, fretful hunger cry must not be neglected; the cause 
must be removed, for it points to malnutrition. 

THE CRY OF THIRST 

One day when lecturing at an Iowa chautauqua, I remained 
in the beautiful park for the noonday meal. It was a warm 
day and the tables in the well-screened dining tent were filled 
with mothers who, like myself, preferred the cool shade of 
the park to the hot ride through the city to the home or hotel 
dinner. At my table a baby was pitifully crying. The mother 
had offered the little child seated in a small uncomfortable 
go-cart, milk, bread, and a piece of cake — all of which were 
ruthlessly pushed aside. My little son, then only four and a 
half, said " Mamma, maybe the baby's thirsty," and up he 
jumped, hurried to the mother's side with his glass of water, 
saying, " I haven't touched it, maybe the baby's thirsty." The 
mother brushed the boy aside, saying, " No, I never give the 
baby water." In spite of the mother's remonstrance, the baby 
cried on and on, and finally on " trying " the water, the child 
drank fully one-half the glass and the crying was hushed. 



WHY BABIES CRY 125 

Babies should be given water regularly — many times every 
day — from birth, in varying amounts from two teaspoons 
to one-half cup, according to the age of the child. The water 
should be boiled for the first few months, and longer if there is 
any suspicion of impurities. 

Milk to the nursing infant is like beefsteak and potatoes to 
the adult; and many times the milk bottle or the breast is just 
as nauseating to the thirsty babe, as meat would be to the very 
thirsty adult whose hunger has previously been fully satisfied. 

THE FRETFUL CRY 

The babe who is wet, soiled, too hot, or is wrapped too 
tightly, or who has on a tight, uncomfortable belly band, or 
whose clothing is full of wrinkles, has only one way to tell 
us of his discomfort, and that is to cry. It is a fretful cry and 
should command an immediate investigation as to the possible 
cause. It takes but a moment to discover a wet diaper; to run 
the hand up the back under the clothes ; to sprinkle with talcum 
if perspiring; to straighten out the wrinkled clothing; to find 
the unfastened pin that pricks; or to loosen the tight band. 
Acquire the art of learning to perform these simple tasks easily, 
and any or all of these services should be rendered without 
taking the child from its bed. 

Let the child early learn to rest happily and quietly in his 
own bed. The pillow or mattress may be turned or perhaps 
the mattress be raised nearer the edge of the basinet. One 
poor youngster instantly stopped his fretful cry when his mat- 
tress was raised four or five inches so he could get the air, at 
the same time taking him out of his hot room to a cooler room 
with raised windows. Babies like cold air. They cry when the 
air is hot, or even warm and close. Every day — rain or 
shine, wind or sleet — ■ babies should nap out of doors on the 
porch, in a well-sheltered corner. A screen or a blanket protects 
from the wind, sleet, or rain; and if the baby's finger tips are 
warm, you can rest assured the feet and body are warm. Scores 
of babies will sleep out on the porch, on the protected fire escape, 
or in a room with opened windows, from one bottle or feeding 
to another; being aroused at the end of the three or four hour 



126 THE MOTHER AND HER CHILD 

interval just enough to nurse, when back they go to their 
delightful, warm nest in the cool, fresh air to sleep for another 
period. Babies should never sleep in a room with closed 
windows. 

One of the incidents that surprised me most in my early 
work with dispensary babies was the utter misconception of the 
purpose of the belly band. Invariably it was put on so tightly 
that I could not slip a finger between it and the babe. It is 
not a surgical instrument, neither is it a truss. These tight 
belly bands are a source of much fretting and crying. 

THE PAIN CRY 

The little pinched look about the face, the drawing up of the 
legs, the jerking of the head, arms, or legs, associated with a 
strong, sharp, unceasing or intermittent cry, demands imme- 
diate attention. Our first work should be to go about quietly, 
painstakingly, and systematically to locate the cause of this 
" cry of pain." 

There are often some accompanying symptoms to the cry 
of pain which demand skilled medical advice and attention, 
such as the arching of the body backward, the drawing of the 
head strongly to one side, the inability to use one side of the 
body, or the presence of fever. There may be an earache, an 
abdominal complication, or a sore throat, any one of which will 
be detected by the skilled doctor. 

Earache frequently occurs in young babies who have been 
taken out of doors without proper protection to the ears; or, 
it may be associated with a cold in the head, which is not 
detected until the mischief has already been done, while the 
resulting running ear tells the tale of woeful suffering. Ear- 
ache must always be thought of as a possible cause when the 
cry of pain accompanies a cold in the head, and if medical aid 
is secured early, the abscess may be aborted and the deafness 
of later years entirely avoided. There is only one home remedy 
for earache, and that is the application of external heat, either 
by a hot-water bottle or hot-salt bag. Medical advice should 
be sought before anything whatsoever is dropped into the baby's 
ear. 



WHY BABIES CRY 127 

In this connection should be mentioned the wild cry at night 
which so often accompanies tuberculosis of the bone. A care- 
ful X-Ray examination will reveal the disease, and proper 
medical measures should be instituted at once. Other fretful 
night crying will be mentioned further on. 

HABIT CRYING 

By the frequent repetition of actions, habits are formed. 
When the baby is two or three days old, he is so new to us 
and we have waited for him so long, and it is such a great 
big world that he has come into, that we jump, dance, and 
scramble to attend to his every need and adequately to provide 
for his every want. At this very early, tender age whenever 
he opens his mouth to cry or even murmur — some fond auntie 
or some overly indulgent caretaker flies to his side as if she 
had been shot out of a gun, grabs him up and ootsey tootsey's 
him about as she endeavors to entertain and quiet him. The 
next time and the next time and the succeeding time he whim- 
pers — like a flash someone dashes to the side of the basket, 
and baby soon learns that when he opens his mouth and yells, 
somebody comes. In less than a week the mischief has been 
done and baby is badly spoiled. No other factor enters so 
largely into the sure " spoiled " harvest as picking a new baby 
up every time he cries. Often in the early days some indulgent 
parent will say, " Oh, don't turn out the light, something might 
happen to the dear little thing" — and old Mother Nature sees 
to it that a constant repetition of " leaving the light on " brings 
its sure harvest of " he just won't go to sleep without the light." 
And then, " just once " he had the pacifier — perhaps to prevent 
his crying disturbing some sick member of the family — and so 
we go on and on. If a thing is bad, it is bad, and a supposedly 
good excuse will not lessen the evil when the habit has been thus 
started and acquired. 

The rocking of babies to sleep may be a beautiful portrayal 
of mother love, but we all pity the child who has to be rocked 
to sleep as much as we do the mother who sits and rocks, want- 
ing, Oh, so much ! to do some work or go for a walk — but 
she must wait till baby goes to sleep. 



128 THE MOTHER AND HER CHILD 

THE TEMPER CRY 

And so now we come to the temper cry — that lusty, strong 
outburst of the cry of disappointment when he finds that all of 
a sudden people have stopped jumping and dancing for his 
every whim. The baby is not to blame. We began something 
we could not keep up. and he — the innocent recipient of all 
our indulgences — is in no sense at fault. It is most cruel to 
encourage these habits of petty indulgence, which must cause 
so much future disappointment and suffering on the part of the 
little fellow as he begins to grow up. 

Nobody is particularly attracted to the spoiled baby. After 
the over-indulgent parent and caretaker have completed their 
thoughtless work, they themselves are ashamed of it and not 
infrequently begin to criticise the product of their own making 
— the formation of these unpleasant bad habits. More than 
anything else, the spoiled child needs a new environment, new 
parents, and a new life. 

THE SPOILED BABY 

Seek to find out if possible — and it usually is possible — just 
what he is crying for. It may be for the pacifier, for the light, 
or to be rocked, jolted, carried, taken up and rocked at night, 
or a host of other trifles; and if he is immediately hushed on 
getting his soul's desire — then we know he is " spoiled." 

The unfortunate thing about it all is that the one who has 
indulged and spoiled the baby usually does not possess the 
requisite nerve, grit, and will power to carry out the necessary 
program for baby's cure. And the pity of it all is that over- 
indulgence in babyhood so often means wrecked nerves and 
shattered happiness in later life. So, fond, indulgent parents, 
do your offspring the very great kindness to fight it out with 
them while they are young, even if it takes all summer, and 
thus spare them neurasthenia, hysteria, and a host of other 
evils in later life. 

This sort of " spoiled baby crying " can be stopped only 
through stern discipline — simply let the baby " cry it out." 
The first lesson may require anywhere from thirty minutes to 
an hour and thirty minutes. The second lesson requires a much 



WHY BABIES CRY 129 

shorter time, and, in normal babies with a balanced nervous 
system, a third or fourth lesson is not usually required. 

THE CRY OF SERIOUS ILLNESS 

The cry of the severely sick child is the saddest cry of all. 
The low wail or moan strikes terror to the saddened mother- 
heart. It is often moaned out when the child is ill with " sum- 
mer complaint " or other intestinal disturbances. Instant help 
must be secured, and, if medical help is not obtainable, remem- 
ber, with but one or two exceptions, you are safe in carefully 
washing out the bowels, in applying external heat and giving 
warmed, boiled water to drink. 

Another cry which demands immediate attention, and the 
faithful carrying out of the doctor's orders, is the hoarse, 
" throaty " cry indicative of croup or bronchitis. 

THE COLICKY CRY 

Perhaps the greatest cause of the most crying during infancy, 
next to that of over-indulgence, is ordinary colic which — 

. . . manifests itself in every degree of disturbance from mere 
peevishness and fretfulness to severe and intensely painful attacks 
in which restlessness passes into grunting, writhing, and kicking; 
the forehead becomes puckered and the face has an agonized 
expression ; the baby tends to scream violently and draws his 
thighs up against his belly, which will usually be found to be hard 
and more or less distended. 

A colicky baby completely upsets the household and greatly 
disturbs the mother, who requires both quiet and rest that she 
may the better produce the life-sustaining stream so much 
needed for the upbuilding and development of the growing 
child. 

COLIC IN THE BREAST-FED 

While colic is so often seen in the bottle-fed babe, it often 
occurs in the breast-fed child, and is usually traceable to some 
error in the mother's diet or to some other maternal nutritional 
disturbance. One mother who was sure she had eaten nothing 
outside the diet suggestions she had received, was requested to 



130 THE MOTHER AND HER CHILD 

bring to the office a fresh voiding of her own urine which was 
found to be highly acid. The administration of an alkaline 
such as simple baking soda or calcined magnesia to the mother, 
corrected this acidity, and the colic in the baby entirely dis- 
appeared. I recall the case of one mother who ate her dinner 
in the middle of the day, with a light meal in the evening and 
thereby stopped the colic in her babe. 

Another source of colic in the breast-fed baby is the unclean 
nipple. The nipples should be washed with soap and water 
and rinsed in boracic acid solution before each nursing. If 
the mother worries greatly, or thoughtlessly " gets very angry " 
just before the nursing hour, there is a substance known as 
" epinephrin " secreted by the glands located just above the 
kidneys which is thrown into the blood stream and which raises 
the blood pressure of the mother and often produces not only 
colic in the babe, but many times throws him into severe con- 
vulsions. 

COLIC IN BOTTLE-FED BABIES 

There are many opportunities for colic in the bottle-fed baby ; 
for instance, dirty bottles, dirty nipples, careless cleansing of 
utensils used in the preparation of baby's food, improper mix- 
tures, too much flour, the wrong kind of sugar, too much cream 
or too little water — all these things help to produce wind under 
pressure in the intestine, which is commonly known as colic. 
Underfeeding or overfeeding, too rapid feeding or too frequent 
feeding also contribute their mite in producing colic. 

As a rule, the bottle-fed child is fed too often. In the new 
born, the interval between feeds should be three hours from 
the start; after six months the interval may be lengthened to 
four hours. 

COLIC AND CHILLINESS 

Hiccough — a spasm of the diaphragm — often accompanies 
colic, and, in the case of infants, is usually due to the swallow- 
ing of air or over-filling the stomach ; gentle massage, external 
heat, and a few sips of very warm water usually corrects the 
condition. 



WHY BABIES CRY 131 

The chilling of the skin very often produces a temporary 
intestinal congestion with colic as the result. Cold feet, wet 
diapers, and loitering at bath are all very likely to produce colic; 
and when it is thus caused by chilling, quickly prepare a bath 
at 100 R, and after immersing the child for five minutes, wrap 
up well in warm blankets. 

THE TREATMENT OF COLIC 

Those of my mother readers who have electric lights in their 
home, will find the photophore to be a source of great comfort 
and convenience; for this simple contrivance is usually able 
to banish colic in a few moments. The photophore is simply 
radiant heat — heat plus light (See Fig. 3) — and as this heat is 
applied to legs and buttocks of the crying child the diaper is 
warmed, the abdomen relaxes, gas is expelled, intestinal con- 
tractions relieved, and the baby is soon fast asleep. 

Occasionally with the aid of the photophore, and even without 
it, the warm two-ounce enema containing a level teaspoon 
of baking soda and a level teaspoon of salt to a pint of water 
when allowed to flow into the bowel, will soon bring down 
both gas and feces to the great relief of the baby. Warm water 
to drink is also very helpful. Putting the feet in very warm 
water is also quieting to the crying colicky babe. 

It is often necessary in cases of repeated and persistent colic, 
to give a full dose of castor oil to clear out the bowel tract. 
Do not jolt or bounce the baby, do not carry him about, and 
don't walk the floor with him. 

Heat him up inside and outside, warm his clothing and his 
bedding, and thus bring about relief without sowing seeds for 
future trouble — the sorrow of a spoiled child. 

One very quiet little baby was one day brought to the dis- 
pensary whose mother said : " Doctor, I didn't bring him 'cause 
he's sick, but 'cause he looks so pale ; he's as quiet as a mouse ; 
he never cries any more since I got to giving him medicine." 
On examination of the baby and on inquiring about the medicine, 
we found that the baby was dead drunk all the time. Some 
" neighbor friend " had told the tired out mother, " Give him a 
teaspoon of whiskey at each feeding and that'll fix him all 



132 



THE MOTHER AND HER CHILD 



right." If a few more states go dry maybe it will not be so 
easy for the ignorant mother to dope and drug her helpless 
baby. 

And neither is paregoric to be administered wholesale for 
colic. It contains an opiate, and should not be given without 
definite orders from a physician. And so as a parting word on 
" Why Babies Cry," we ask each mother to run over the follow- 
ing summary of the chapter, and thus seek to find out why 
her baby cries. 



BABY CRIES BECAUSE I 



He is hungry. 

He is thirsty. 

He has been given a dirty bottle. 

His mother has failed properly 

to cleanse the nipples. 
His food is not prepared right. 
His food is too cold. 
His bowels are constipated. 
His band is too tight. 
His clothes are wrinkled. 
His diaper is wet. 
He is too hot. 
He wants fresh air. 



He is too cold. 

He is in pain. 

He is very sick. 

His throat is sore. 

His ear aches. 

He has been rocked, carried, or 
bounced. 

He has been given a pacifier. 

He has had too much excite- 
ment. 

His mother has eaten the wrong 
food. 



CHAPTER XV 
THE NURSING MOTHER AND HER BABE 

HAPPY is the mother, and thrice blessed is the babe when 
he is able to enjoy the supreme benefits of maternal nurs- 
ing. The benefits to the child are far reaching; he stands a better 
chance of escaping many infantile diseases; the whole outlook 
for health — and even life itself — is greatly improved in the 
case of the nursing babe, as compared with the prospect of the 
bottle-fed child. Maternal nursing lays the foundation for 
sturdy manhood and womanhood. 

Out of every one hundred bottle-fed babies, an average of 
thirty die during the first year, while of the breast-fed babies, 
only about seven out of every one hundred die the first year. 
At the same time, nursing the babe delivers the mother from all 
the work and anxiety connected with the preparation of the 
artificial food, the dangers and risks of unclean milk, and the 
ever-present fear of disease attendant upon this unnatural feed- 
ing. The mother who nurses her child can look forward to a 
year of joy and happiness; whereas, if the babe is weaned, she 
is compelled to view this first year with many fears and fore- 
bodings. Mother's milk contains every element necessary for 
the growth and development of the child, and contains them 
in just the proportions required to adapt it as the ideal food 
for that particular child. 

A dirty baby, properly fed, will thrive. A baby deprived of 
fresh air, but wisely fed, will survive and even develop into a strong 
healthy man or woman. But the baby raised according to the latest 
and most approved rules of sanitation and hygiene, if improperly 
fed, will languish and die. 

133 



134 THE MOTHER AND HER CHILD 

HYGIENE OF NURSING MOTHERS 

Outings and Exercise. It is most highly important that the 
nursing mother should be able thoroughly to digest her food; 
otherwise the flow of milk is likely to contain irritants that 
will disturb the baby's digestion, even to the point of making 
him really sick. In order to avoid these complications, exercise 
and outings are absolutely essential for the mother. A vigorous 
walk, gardening, light housework or other light athletics, 
greatly facilitate digestion and increase the bodily circulation, 
as well as promote deep breathing, all of which are of paramount 
importance to a good appetite and good digestion. 

The Bowels. The bowels should move regularly and normally 
once or twice during the twenty-four hours. Unfortunately, 
this is not usually the case; and in this connection we would 
refer our reader to the chapter on " The Hygiene of Preg- 
nancy," particularly those sections relative to the care of the 
bowels, recipes for bran bread, lists of laxative foods and other 
suggestions pertaining to the hygiene of the nursing mother. 

Sleep. Nothing less than eight hours sleep will suffice for 
the nursing mother, and during the day she should take at least 
one nap with the baby. 

Care of the Skin. Salt-rub baths are very beneficial taken 
once a week. The daily cold-friction rub described elsewhere, 
will tone up the system and increase digestion and improve the 
general well being. The soap wash may be taken once a week. 
The thorough cleansing of the breasts, and the frequent chang- 
ing of the undergarments, will help to keep the baby happy; 
for oftentimes it is the odor of perspiration as well as the smell 
of soiled clothing that spoils the appetite of the baby, causing 
it to refuse food. 

Recreation. Pleasant diversion is very essential for the 
mother, and should be indulged in at least once a week. The 
bedtime hours, however, should not be interfered with and the 
recreation should be selected with a view to amuse, refresh 
and create a harmless diversion for the mother's mind. Under 
no circumstances should the mother settle down to the thought : 
" No, I can't go out any more. I can't leave my baby." You 



THE NURSING MOTHER AND HER BABE 135 

should get away from the baby a short time each day, and 
go out among your former friends and acquaintances. Many 
a wrecked home — a shattered domestic heaven — dates its 
beginnings back to the days when the over-anxious young 
mother turned her back on her husband and looked only into 
the face of her (their) child. Nothing should come in between 
the filial friendship of husband and wife, not even their child. 
So, dear mother, if you can, go out occasionally, away from the 
baby, and enjoy the association of your husband and keep in 
touch not only with his interests, but with the outside world. 
You will come back refreshed and wonderfully repaid, and the 
face of the adored infant will appear more beautiful than ever. 

DIET OF THE NURSING MOTHER 

The general suggestions on diet which we made to the ex- 
pectant mother are also valuable for the nursing mother. The 
food should be appetizing, nutritious, and of a laxative nature. 
Three meals should be eaten : one at seven a. m., one at one p. m. 
and one about six-thirty at night, with the heaviest meal usually 
at one p. m. As the mother usually wakens at five o'clock, or 
possibly earlier, she should be given a glass of milk, cocoa, or 
eggnog. If she awakens at six, nothing should be taken until 
the breakfast, which should consist of a good nourishing meal, 
such as baked potatoes with white sauce, poached eggs, cereal, 
milk or cocoa, prunes, figs, or a baked sweet apple, with bread 
and butter, etc. 

From that hour until one p. m. only water is taken, and several 
glasses are urged during this interval. With nothing between 
meals but water and a little outdoor exercise, a good appetite 
is created for the one p. m. meal which should abundantly 
supply and satisfy the hungry mother; and then again, nothing 
is to be taken between dinner and supper but water. And after 
the supper hour, a walk out into the cool night air should be 
enjoyed with the husband and on going to bed about ten p. m., 
an eggnog or glass of milk may be taken. At the close of the 
other meals a cup of oatmeal gruel or milk or any other nourish- 
ing liquid may be enjoyed. 

The eating of food or the drinking of nourishing drinks 



136 THE MOTHER AND HER CHILD 

between the meals not only interferes with digestion and dis- 
turbs the mother, but it also upsets the baby; and it is often 
the reason why the appetite of the mother is so deranged at 
the meal time, her spirits depressed, and her milk diminished. 
Plenty of good nourishing food, taken three times a day with an 
abundance of water drinking between the meals, together with 
? free happy frame of mind occasioned by the recreation before 
mentioned, usually produces good milk and plenty of it. A nap 
between meals will probably produce more milk than eating 
between meals. 

OBJECTIONABLE FOODS 

All foods that cause indigestion in the mother or babe should 
be avoided. 

Some mothers continue to eat tomatoes, peaches, sour salads, 
acid fruits, and it appears in no way to interfere with baby's 
comfort; but they are the exception rather than the rule. 
Usually tomatoes, acid salad dressings, and mixed desserts must 
be avoided. Each mother is a law unto herself. Certainly 
none of our readers will selfishly continue any food she feels 
will make her baby cry. All acid fruits, rich desserts, certain 
coarse vegetables, concoctions of all descriptions such as rare- 
bit, condiments, highly seasoned sauce, etc., should be avoided. 

Acid fruitades, such as lemonade, limeade and orangeade, can 
be taken by a small per cent of nursing mothers ; and, since 
fruit acids are neutralized and alkalized in the process of diges- 
tion and assimilation, and since they are the very fruit-drinks 
we prescribe for patients suffering with an increased acidity, 
it would appear that they were in every way wholesome for the 
mother — if they in no way interfere with the baby. Prac- 
tically, they do as a rule disturb the baby's digestion and should 
be avoided by those mothers who have found this to be the 
case. 

CAKED BREASTS 

During the first week of lactation the milk tubes of the 
breasts very often become blocked and the breasts become en- 
gored with milk, this condition being known as " caked 



THE NURSING MOTHER AND HER BABE 137 

breasts." At this particular time of the baby's life, he takes 
little more than an ounce of milk at a feed; so, beside the in- 
coming engorgement of milk, an additional burden is thrown 
upon the milk tubes of the breasts in that they are not entirely 
emptied each nursing time by the young infant. When the 
breasts threaten to " cake," immediate steps must be taken to 
relieve the condition — to empty the breasts — and this is 
usually accomplished in the following manner: with hands well 
lubricated with sweet oil or olive oil the nurse begins gentle 
manipulation of the breasts toward the nipple in circular strokes, 
with the result that the milk soon begins to ooze out. This 
massage should be continued until relief is obtained; or the 
breast pump may be applied. Hard nodules should not be 
allowed to form or to remain in the breasts. Hot compresses 
(wrung from boiling water by means of a "potato ricer") 
may be applied to the caked breast which is protected from the 
immediate heat by one thickness of a dry blanket flannel. These 
hot compresses should be removed every three minutes until 
three have been applied, then an ice water compress is quickly 
applied, to be followed by more hot ones and then a cold; 
and so on, until as many as four sets each have been admin- 
istered. 

Gentle massage may again be administered and it will be found 
that they empty now with greater ease because of the preceding 
heat. After the breasts have been emptied, and thoroughly 
washed with soap suds and carefully dried, they should be 
thickly covered with cotton batting and firmly compressed 
against the chest wall by a snug-fitted breast binder, which 
serves the double purpose of relieving pain by not allowing the 
breasts to sag downward, at the same time preventing an over- 
abundant secretion of milk by diminishing the blood supply to 
the glands of the breast. In case the persistent manipulation 
of the breast and the use of the breast pump do not relieve the 
condition, and if the repeated effort day after day seems to 
avail nothing; then, as a rule, we must look for a breast abscess 
to follow if the breasts are not immediately " dried up." In all 
such cases of engorgement, the attending physician should be 
notified at once. 



138 THE MOTHER AND HER CHILD 

SORE NIPPLES 

The nipple must be kept dry between nursings, which should 
be limited to twenty minutes. Regularity should be main- 
tained. The nipples should never be touched or handled by 
hands that have not been scrubbed with soap and a nail brush. 
During the early nursing days they are wet much of the time 
and are subject to much stress and strain in the " pulling effort " 
of the baby, as a result of which they become very tender, 
chapped, cracked, and often bleed. Allowing the baby to go to 
sleep with the nipple in his mouth also exposes the nipple to 
unnecessary moisture which increases the possibility of painful 
cracking. The pain occasioned by nursing at this time is truly 
indescribable, and is most often the cause of absolute refusal 
on the part of the mother to nurse her babe — with the result 
that it is put on the bottle. Again, the fear and dread of being 
hurt so often tends to diminish the flow of milk. It is entirely 
possible so to prepare the nipple for this exposure, during the 
last months of pregnancy, that all this discomfort and pain may 
be entirely avoided (See chapter, "The Hygiene of Preg- 
nancy "). 

Before the mother is put to rest after the birth of the baby 
the breasts are prepared as follows : A thorough cleansing 
with soap and water is followed by a careful disinfection with 
alcohol which leaves the nipple perfectly dry. A soft sterile 
pad is then applied and held in place by a breast binder. Before 
and after each nursing the nipple and surrounding area is 
swabbed with boracic acid (saturated solution) and carefully 
dried by applying a clean, dry, sterile pad. 

Painful cracks and fissures are nearly always due to lack of 
the care described above, and are almost wholly preventable. 
When the first crack appears and nursing becomes painful, the 
baby's mouth should not touch the nipple again until healing 
has taken place. A thorough cleansing with boiled water should 
be made and then the sterile nipple shield should be applied 
through which baby will get abundant satisfaction, while the 
mother is spared the pain, and the nipple has an opportunity to 
get well. 



THE NURSING MOTHER AND HER BABE 139 

In the case of sore and cracked nipples, thorough cleansing 
with boiled water and boracic acid solution follows each nurs- 
ing seance; and, after careful drying, balsam peru — equal 
parts with glycerine — may be applied with a tiny piece of 
sterile gauze or cotton; a sterile cotton pad is then applied to 
each breast which is held in place by a breast binder. 

The nipple shield, when employed, is boiled after each nurs- 
ing and washed in boracic acid solution just before each 
nursing. The strictest cleanliness must be observed, and then 
we hope to bring relief and comfort to the mother, and effect 
the saving of nature's best food for the baby. 

CONSTITUENTS OF MOTHER' S MILK 

Mother's milk — that wonderfully adaptable, ever-changing 
food, so accurately and scientifically suited to the hourly and 
daily needs of the growing child — is composed of five different 
parts, totally unlike in every particular, and each part exactly 
suited to the needs which it supplies. The cream of the milk, 
as well as the lactose or sugar, builds up the fatty tissues of the 
body as well as helps provide the energy for crying, nursing, 
kicking, etc. The proteins (the curd of the milk) are exceed- 
ingly important; they are especially devoted to building up the 
cells and tissues of the body of the growing child. The salts 
form a very small part of the baby's food, but an important one, 
for they are needed chiefly for the bones and the blood. The 
fats, sugars, proteins, and salts, taken together, form the solids 
of mother's milk, and are held in solution in the proportion of 
thirteen parts of solids to eighty-seven parts of water; which 
so holds these solids in solution that the baby can digest and 
assimilate these necessary food elements. The mother's milk 
increases in strength day by day and month by month as the 
baby grows, and is the only perfect infant food on earth. 

THE TIME OF THE FIRST FEEDING 

Soon after the birth of the baby the wearied mother seeks 
rest — she usually falls into a quiet, restful slumber ; the baby 
likewise goes to sleep and usually does not awaken for several 
hours. After six or eight hours the child is put to the breast 



140 THE MOTHER AND HER CHILD 

and he begins to nurse at once, without any special help. This 
first nursing should be discontinued after four or five minutes, 
while he is put to the other breast for the same length of time. 

If there is difficulty in sucking, a bit of milk may be made 
to ooze out on the clean nipple, while the baby's lips are pressed 
to it, after which the nurse gently presses and rubs the breasts 
toward the nipple. After the nursing, the nipples should be 
elongated, if necessary, by rubbing, shaping, or breast pump. 

The baby gets but little nourishment during the first two days, 
but that which he does get is essential ; for the colostrum — 
the first milk — is highly laxative in nature and serves the 
important purpose of cleaning out the intestinal tract of that 
first tarry, fecal residue, the meconium. This early sucking 
of the child accomplishes another purpose besides the obtaining 
of this important laxative — it also reflexly increases the con- 
tractibility of the muscles of the womb, which is an exceed- 
ingty important service just at this time. 

Should the mother or caretaker feel that baby will starve 
before the milk comes, or that it is necessary to provide " sweet- 
ened water ; " let us assure them that nothing is needed except 
what nature provides. Nature makes the babe intensely hungry 
during these first two days, so that he will suck well, and if he 
is fed sweetened water, gruel, or anything else, he will not 
suck forcefully; and so nature's plan for securing extra or 
increased uterine contractions and the stimulation of the breast 
glands will be seriously interfered with. 

WATER DRINKING 

As soon as the new born babe is washed and dressed he is 
given two teaspoons of warmed, boiled water; and this prac- 
tice is continued every two hours during the day, until as much 
as two to four ounces of unsweetened water is taken by the tiny 
babe during the twenty-four hours. Inanition fever — the fever 
that sometimes follows a failure to give water to the new born 
infant — is thus avoided. The bottle from which the water 
is given should be scalded out each time, the nipple u oiled, and 
just before the "water nursing" the nipple should be swabbed 
with boracic acid solution. 



THE NURSING MOTHER AND HER BABE 141 

REGULARITY IN FEEDING 

From earliest infancy the baby should be nursed by the 
" clock," and not by the " squawk." Until he reaches his sixth- 
month birthday, he is fed with unerring regularity every three 
hours during the day. Asleep or awake he is put to the breast, 
while during the night he is allowed to sleep as long over the 
three-hour period as he will. Babies are usually nursed at 
night: during the early weeks, at nine o'clock in the evening, 
at midnight, and at six o'clock in the morning. After four 
months all nursing after ten p. m. may be omitted. 

The baby is ordinarily allowed to remain at the breast for 
about twenty minutes. He may often be satisfied with one 
breast if the milk is plentiful; if not, he is given both breasts; 
and may we add the following injunction? insist that nothing 
shall go into your baby's mouth but your own breast milk and 
warm or cool-boiled water; no sugar, whiskey, paregoric, or 
soothing syrup should be given, no matter how he cries. Never 
give a baby food merely to pacify him or to stop his crying; it 
will damage him in the end. More than likely he is thirsty, 
and milk to him is what bread and meat are to you, neither 
of which you want when you are thirsty. 

POSITION OF MOTHER DURING THE NURSING 

A perfectly comfortable position during nursing for both 
mother and babe is necessary for satisfactory results. During 
the lying-in period the mother should rest well over on her side 
with her arm up and her hand under her head, the other hand 
supports the breast and assists in keeping the nipple in the baby's 
mouth, as well as preventing the breast from in any way inter- 
fering with baby's breathing. A rolled pillow is placed at the 
mother's back for support. 

After the mother leaves the bed, she will find a low chair 
most convenient when nursing the baby, and if an ordinary 
chair be used, she will find that a footstool adds greatly to her 
comfort. Once during the forenoon and once during the after- 
noon the nursing mother will find it a wonderful source of rest 
and relaxation if she removes all tight clothing, dons a com- 
fortable wrapper, and lies down on the bed to nurse her babe; 



142 THE MOTHER AND HER CHILD 

and as the babe naps after the feed, she likewise should doze 
and allow mother nature to restore, refresh, and fit her for 
restful and happy motherhood. 

Worry, grief, fatigue, household cares, loss of sleep, social 
debauches, emotional sprawls — all debilitate the mother, and 
usually decrease the flow of milk. 

NURSING WHEN ANGRY AND OVERHEATED 

Overheating, irritability, and sudden anger, almost invariably 
tend to raise the blood-pressure, which means the entry into 
the blood stream of an increased amount of epinephrin, which 
disturbs the baby greatly, often throwing him into convulsions 
or other sudden, acute illness. 

Menstruation often interferes with the nursing mother, 
the milk becoming weaker at this time; however, if the infant 
continues to gain and the mother feels comparatively well, no 
attention need be paid to this fact. 

Another pregnancy demands a drying up of the breast at 
once, as the tax is too great on the mother. 

THE STOOLS 

The stools of the breast-fed baby do not require as much 
attention as those of the bottle-fed child. In cases of con- 
stipation, after four months, from one teaspoon up to one-half 
cup of unsweetened prune juice may be given one hour before 
the afternoon feed. 

In instances of colic with signs of fermentation in the stool, 
the mother may take several doses (under her physician's 
orders) of common baking soda; or, if she is constipated, cal- 
cined magnesia will usually right the condition. Nature's 
mother milk is so beautifully adapted to the baby's needs that it 
is the rule for baby to have perfectly normal stools. 

SYMPTOMS OF SUCCESSFUL NURSING 

A happy baby is a satisfied baby. He lies quietly in a sleepy, 
relaxed condition if he has enough to eat, provided he is other- 
wise comfortable and dry. He awakens at the end of two hours 
and perhaps cries; but plain, unsweetened, warm, boiled water 



THE NURSING MOTHER AND HER BABE 143 

quenches his thirst, and he lies content for another hour, when 
he is regularly nursed. He gains on an average of about one 
ounce a day. 

EARMARKS OF UNSUCCESSFUL NURSING 

Constant discomfort, vomiting, fretful crying, passing and 
belching of gas, colicky pain, disturbed sleep, greenish stools 
with mucus, are among the more prominent earmarks of unsuc- 
cessful nursing. These symptoms appearing in a pale, flabby, 
listless, indifferent or cross baby, with steady loss of weight 
continued over a period of three or four weeks, point to " nurs- 
ing trouble ; " which, if not corrected, will lead to that much 
dreaded infantile condition — malnutrition. 

Bolting of food or overeating results in vomiting and gas, 
and thus interferes with normal nursing, as also may tongue- 
tie. A condition in the mouth, medically known as " stomatitis," 
and commonly known as " thrush," often gives rise to a fretful 
cry when nursing is attempted. In the first place, the baby can- 
not " hold on " to the nipple ; while, in the second place, it hurts 
his inflamed mouth when he makes an effort to nurse. 

Long continued nursing covering three-fourths of an hour 
or more, seizing of the nipple for a moment and then discard- 
ing it, apparently in utter disgust, are the earmarks of very 
scanty milk supply and should receive immediate attention. 

AIDS TO THE MILK SUPPLY 

Believing that many more mothers than do so should nurse 
their babies, we have carefully tabulated a number of aids to 
the milk supply, which we hope will be most earnestly tried 
before the baby is taken from the breast — for so many, many 
more bottle-fed babies die during the first year than the breast 
fed. The dangers of infection, the worry of the food prepara- 
tion, the uncertainty of results, all call for a most untiring 
effort on the part of every doctor, nurse, and mother, in their 
endeavors to secure maternal nursing. The following is a 
summary of " aids to the milk supply : " 

1. Regular periodical sucking of the breasts from the day of 
baby's birth. 



144 THE MOTHER AND HER CHILD 

2. Systematic applications of alternate hot and cold com- 
presses, followed by massage to the breasts. 

3. Three good nourishing meals each day, eaten with merri- 
ment and gladness of heart. 

4. A glass of " cream gruel," milk, cocoa, or eggnog at the 
close of each meal, with a glass just before retiring. 

5. Three outings each day in the open air. 

6. Nurse the baby regularly and then turn its care over to 
another, you seek the out of doors and engage in walking, row- 
ing, riding and other pleasurable exercise. 

7. Take a daily nap. 

8. You can bank on fretting and stewing over the hot cook 
stove to decrease your milk. It seldom fails to spoil it. 

9. Regular body bathing, with cold friction rubs to the skin. 

10. A happy, carefree mental state. Nothing dries up milk 
so rapidly as worry, grief, or nagging. 

11. The administration, preferably in the early days, of 
desiccated bovine placenta ; although it may be given at any time 
during the period of nursing. 

WHEN THE BABY SHOULD NOT BE NURSED 

As much as we desire maternal nursing for the babe, there 
do occur instances and conditions which demand a change to 
artificial feeding, such as the following: 

1. A new pregnancy. 

2. Mothers with uncontrollable tempers. 

3. Cases of breast abscess. 

4. Prolonged illness of the mother with high fever. 

5. Wasting diseases such as tuberculosis, Bright's disease, 
heart disease, etc. 

6. Maternal syphilis. 

7. When maternal milk utterly fails, or is wholly inadequate. 

When a maternal anesthetic is to be administered, or in case 
of inflammation of the breast or during a very short illness not 
covering more than two or three days, then the breast pump 
may be used regularly every three hours to both breasts; the 



THE NURSING MOTHER AND HER BABE 145 

baby may be artificially fed and then returned to the breast after 
the effects of the anesthetic has worn off or the temperature 
has been normal for twenty-four hours. 

There may also appear definite indications in certain children 
which make it imperative that the nursing child should early be 
weaned. These manifestations of disordered nutrition and 
failing health admonish us to put the baby on properly modified 
milk, or to transfer it to a wet nurse. 

These conditions are: 

1. Progressive loss in weight. 

2. A bad diarrhea of long standing; one which does not 
yield to the usual remedies, at least not as long as the baby 
continues to feed from the breast. These diarrheas are espe- 
cially serious when accompanied by a steady loss in weight. 

3. Excessive vomiting accompanied by progressive loss in 
weight. 

THE WET NURSE 

Because of the rarity of good, healthy wet nurses, it is always 
better to attempt to feed the baby with scientifically modified 
milk (not proprietary foods), good, clean, cow's milk properly 
modified to suit the weight and age of the child. We put weight 
first, for we prepare food for so many pounds of baby rather 
than for the number of months old he is. 

If modified food has failed and the best specialist within 
your reach orders a wet nurse; she must have the following 
qualifications : 

1. She must be free from tuberculosis and syphilis. 

2. She should be between twenty and thirty years of age. 

3. She should abstain from all stimulants. 

4. She should be amiable, temperate, and should sense her 
responsibility. 

If an unmarried mother of her first child is engaged as a 
wet nurse, she should not be " stuffed " or allowed to overeat, 
which is commonly the result of moving her from her lower 
life into more comfortable surroundings, or given ale or beer 
to increase her milk. She should continue her normal eating, 
take light exercise, which does not mean the scrubbing of 



146 THE MOTHER AND HER CHILD 

floors or doing the family washing, and live under the same 
hygienic regime outlined for the nursing mother. Should she 
be the mother of the second or third illegitimate child, then 
she is quite likely to be mentally deficient and she should not 
be engaged. Her own babe will have to be fed artificially as 
very few mothers can endure the strain of two suckling chil- 
dren. 

The baby's own mother should keep general supervision and 
not turn her babe entirely over to the care of the wet nurse. 
Remember always that no one in the wide world will ever 
take the same mother interest in your offspring that can spring 
from your own mother heart. 



CHAPTER XVI 
THE BOTTLE-FED BABY 

IN taking up the subject of the bottle-fed baby, we must 
repeat that the only perfect baby food on earth is the milk 
that comes from the breast of a healthy mother. 

But sudden illness, accident, chronic maladies, or possibly 
the death of the mother, often throw the helpless babes out into 
a world of many sorts and kinds of artificial foods — foods 
that are prepared by modifying cow's, ass', or goat's milk ; foods 
arranged by the addition to the milk of various specially pre- 
pared cereals, albumens or malted preparations, otherwise known 
as " proprietary foods." We shall endeavor, then, in this chap- 
ter and in that on " the feeding problem," to lay down certain 
general suggestions to both the nurse and the mother, which 
may assist them in their effort to select the food which will 
more nearly simulate nature's wondrous mother-food, and which 
will, at the same time, be best suited to some one particular 
baby. 

THE HOURLY SCHEDULE 

The normal baby, from birth to six months, should receive 
properly prepared nourishment every three hours, beginning 
the day usually at six a. m. , the last feeding being at nine p. m. 
During the early weeks an additional bottle is given at midnight, 
but this is usually discarded at four months, at which time the 
last feeding should be given at about ten instead of at nine at 
night. 

Should the baby continue to awaken during the night before 
six in the morning, unless he is under weight, a bottle of warm, 
boiled, unsweetened water should be given. 

147 



148 THE MOTHER AND HER CHILD 

QUANTITY OF FOOD 

The quantity of food to be given is always determined by 
the size of the baby's stomach, which, of course, depends some- 
what upon the age of the child; for instance, the stomach of 
the average baby one week old holds about one ounce, while at 
the age of three months the stomach holds five ounces; so it 
would not only be folly to give two ounces at one week and 
seven ounces at three months, but it would also be very detri- 
mental to the babe, causing severe symptoms due to the over- 
loading of the stomach. 

Careful study of the size of the stomach at different ages in 
infancy, together with the quantity of milk drawn from the 
breast by a nursing baby, has led to the following conclusions 
regarding the capacity of the baby's stomach : 

AGE QUANTITY 

I — 4 weeks i — 2 ounces 

4 weeks — 3 months 2 l / 2 — 4 ounces 

3 months — 6 months 4 — 6 ounces 

6 months — 1 year 6 — 8 ounces 

REFRIGERATOR NECESSITY 

It is highly important that the day's feedings be kept in a 
cold place, free from the odors of other foods as well as free 
from dust, flies, and filth. In order that this may be accom- 
plished, the well-protected bottles, each containing its baby- 
meal, are placed in a covered pail containing ice and water. 
This covered receptacle is now put in an ice box; and, in order 
that our most economical reader — one who may feel that she 
cannot afford to keep up the daily expense of the family refrig- 
erator — may herself prepare a simple home refrigerator, the 
following directions are given (Fig. 9). 

HOMEMADE ICE BOX 

Procure a wooden box about eighteen inches square and six- 
teen or eighteen inches deep and put four inches of sawdust 
into the bottom.; now fill in the space between a ten-quart pail, 
which is set in the middle of the box with more sawdust. A 
cover for the box is now lined with two or three inches of 



THE BOTTLE-FED BABY 



149 







Fig. 9. Homemade Ice Box 



150 THE MOTHER AND HER CHILD 

newspaper, well tacked on, and is fastened to the box by hinges. 
We are now ready for the inside pail of ice, into which is 
carefully placed the well-protected bottles of milk, all of which 
is then set into the ten-quart pail in the box. Five cents worth 
of ice each day will keep baby's food cool, clean, and provide 
protection against the undue growth of germs. 

PREPARING THE BOTTLE 

At each feeding hour, one of baby's bottled meals is taken 
from the ice box and carefully dipped in and out of a deep cup 
of hot water. A very convenient receptacle is a deep, quart 
aluminum cup, which may be readily carried about. The hot 
water in the cup should amply cover the milk in the bottle 
(Fig. 10). 

To test the warmth allow a few drops to fall on the inner 
side of the arm, where it should feel quite warm, never hot. 
A baby's clean woolen stocking is now drawn over the bottle, 
which keeps it warm during the feeding. No matter how great 
the danger of offending a fond grandparent or a much adored 
friend never allow anyone to put the nipple in her mouth to make 
the test for warmth of baby's food. 

There are many contrivances, both electrical and alcoholic, 
for heating baby's bottle, many of which are both convenient 
and inexpensive. 

POSITION DURING FEEDING 

And now we realize that we are about to advise against the 
time-honored injunction which has been handed down from 
" Grandma This " and " Mother That " to all young mothers who 
have lived in their neighborhoods : " My dear young mother, 
if you can't nurse your precious infant, you can at least 
' mother it ' at the nursing time by holding it in your arms and 
gently rocking it to and fro as you hold the bottle to its lips." 
This so-called " mothering " has resulted in regurgitation, 
belching, and numerous other troubles, as well as the formation 
of the " rocking habit." 

A young mother came running into my office one day saying : 
"Doctor, it won't work, the food's all wrong; my baby is not 



THE BOTTLE-FED BABY 



151 



going to live, for he throws up his food nearly all the time." 
We arranged to be present when the next feeding time came 
and watched the proceedings. A dear old friend had told her 
" she must ' mother ' her baby at the nursing time," and so she 
had held the child in a semi-upright position as she endeavored 
to hold the bottle as near her own breast as was possible. The 
hole in the nipple was a bit large, which occasioned the subse- 
quent bolting of the food, and then to continue the " mothering " 




Fig. 10. Heating the Bottle 

she swayed him to and fro, all of which was interrupted sud- 
denly by the vomiting of a deluge of milk. 

I drew the shade in an adjoining room, opened the windows, 
and into a comfortable carriage-bed I placed the baby on his 
side. Seating myself beside him I held the warm, bottled meal 
as he nursed. Several times I took it from his mouth, or so 
tipped it that " bolting " was impossible. Gradually, carefully, 
and slowly, I took the empty bottle away from the sleepy 
babe, and as I closed the door the mother said in anxious 
amazement : " He won't forget I'm his mother if I don't hold 



152 THE MOTHER AND HER CHILD 

him while he nurses ? " You smile as I smiled at this girl- 
mother's thought ; but, nevertheless there are many like her — 
anxious, well-meaning, but ignorant. 

The infant stomach is little more than a tube, easily emptied 
if the baby's position is not carefully guarded after nursing. 
No bouncing, jolting, patting, rocking, or throwing should take 
place either just before, during, or immediately after meals. 

TIME ALLOWANCE FOR ONE FEEDING 

From twelve to twenty minutes is long enough time to spend 
at a bottle meal. The nipple hole may have to be made larger, 
or a new nipple with a smaller hole may have to be purchased. 
When new, you should be able to just see a glimmer of light 
through the hole, and if the infant is too weak to nurse hard, 
or the hole too small, it may be made larger by a heated hatpin 
run from the inside of the nipple out ; great care must be taken, 
else you will do it too well. If the nipple hole is too large, bolting 
is the sure result; while too small a hole results in crying and 
anger on the part of the hungry child, because he has to work 
too hard to get his meal. 

AFTER THE FEED 

We have seen some mothers, in their anxiety to prevent the 
sucking in of air from the emptied bottle, rush in and jerk 
the nipple from the going-to-sleep babe so forcibly that all 
thoughts of sleep vanished and a crying spell was initiated. 
The tactful mother is the quiet one who slowly, quietly, draws 
the empty bottle with its " much loved nipple " from the lips. 
If you observe that the babe is going to sleep, with an occa- 
sional superficial draw at the nipple, wait a moment; he will 
drop it himself, and you can pick it up as you quietly leave 
the room. In all instances, whether it be indoors or out of doors, 
arrange the babe in a comfortable sleeping position, remem- 
bering that nursing is warm exercise and the babe gets uncom- 
fortably sweaty if overbundled, especially about the head and 
neck. No one should unnecessarily touch the babe immediately 
after feeding; even his diaper may be changed without awaken- 
ing him while he is thus lying quietly in his bed. 



THE BOTTLE-FED BABY 153 

INTERVALS BETWEEN MEALS 

The three-hour interval is reckoned from the beginning of 
the meal, and not from its close. More than two hours is 
spent in the stomach digestion, and any food or sweetened 
water which may enter between meals only tends to cause 
indigestion and other disturbances. And that this important 
organ may have a bit of rest, we fix the interval at three hours, 
which in our experience and that of many other physicians, has 
yielded good results. As a rule we have no regurgitation and 
no sour babies on the three-hour schedule. Sick babies, very 
weak babies, and their feeding time, will be discussed in a 
later chapter. 

ADDITIONAL FOODS 

At six months, and often as early as four, in cases of con- 
stipation, unsweetened, well-strained prune juice may be given, 
beginning with one-half teaspoon one hour before the after- 
noon feed and increasing it daily until two tablespoons are 
taken. At six months, both orange juice and vegetable broths 
are given, whose vegetable salts add a very important food 
element to the baby's diet — an element which our grandmothers 
thought could only be obtained through the time-honored " bacon 
rind " of by-gone days. 

Orange juice is also unsweetened and well strained, and is 
administered in increasing amounts, beginning with one-half 
teaspoon one hour before the afternoon feeding, until the 
juice of a whole orange is greedily enjoyed by the time of the 
first birthday. The vegetable juices are obtained from cut-up 
spinach, carrots, tomatoes, and potatoes, strained, with a flavor 
of salt and onion — really a bouillon — and is given just before 
the bottle at the six p. m. feeding. They are also begun in 
teaspoon amounts. 

FOOD FOR THE TRAVELING BABE 

Baby travel should be reduced to a sheer necessity; never 
should the babe be subjected to the exposure of disease germs, the 
change of food, the possibilities of draughts and chilling, for 



154 THE MOTHER AND HER CHILD 

merely a pleasure trip — the risks are too great and the pos- 
sibilities of future trouble too far reaching. 

If you are in touch with the milk laboratory of a large city, 
you will find that they make a specialty of preparing feedings 
which are good for a number of days for the traveling baby, 
and we strongly advise that their preparations be accepted; but 
in the event of not being in touch with such a laboratory we 
suggest the making of a carrying ice-box covered with wicker, 
which must be kept replenished with ice. Food kept in such 
a device may be kept fresh for twenty-four to forty-eight hours. 
Plans other than the laboratory preparations or the ice-box 
are risky, and should not be depended upon. 

Many of our railway dining cars now pick up fresh, certified 
milk at stations along the line for use on their tables, and 
where such is the case fresh preparations of milk may be made 
on a trans-continental trip by the aid of an alcohol stove. 
Malted milk may also be used, provided you have accustomed 
the baby to its use a week before leaving home, by the gradual 
substitution of a fourth to a half ounce each day in the daily 
food; all of which, of course, should be done under your 
physician's direction. 

If possible, leave baby at home in his familiar, comfortable 
environment in the care of a trained nurse and a trusted relative, 
and under the supervision of the baby's own physician. He 
is much better off, much more contented, and we are all aware 
of the fact that contentment and familiarity of sights and 
people promote good appetite, good digestion, and happiness — 
the very essentials of success in baby feeding. We speak 
touchingly and sympathetically to the mother who must leave 
her babe ; and likewise we wish to cheer her as we remind her 
that by wireless messages and night letters it is possible to 
keep in touch with loved ones though a thousand miles away. 

The sanitation and modification of cow's milk, as well as 
stools, etc., are taken up in later chapters. 

RULES FOR THE BOTTLE-FED 

1. Never play with a baby during or right after a meal. 

2. Lay the baby on his side when nursing the bottle. 



THE BOTTLE-FED BABY 155 

3. Three full hours should intervene between feedings. 

4. Don't give the food too hot — it should just be warm. 

5. Make the test for warmth on the inner side of your arm. 

6. Give a drink of water between each meal if awake. 

7. Never save the left-overs for baby. 

8. If possible, give three feedings each day in the cool air, 
with baby comfortably warm. 

9. Do not jump, bounce, pat, or rock baby during or after 
meals. 

10. Never coax baby to take more than he wants, or needs. 

11. No solid foods are given the first year. 

12. Orange juice may be given at six months; while, after 
four months, unsweetened prune juice is better than medicine 
for the bowels. 



CHAPTER XVII 
MILK SANITATION 

COWS milk, like mother's milk, is made up of solids and 
water. In a previous chapter Ave learned that in one- 
hundred parts of mother's milk, eighty-seven parts were water 
and thirteen parts were solid. These thirteen parts of solids 
consist of sugar, proteins, and salts ; this is likewise the case 
with cow's milk, except that in the case of the cow's milk, the 
sugar is decreased while the proteins are increased as will be 
noted by the accompanying comparative analysis: 

mother's milk 

Fat % 4.00 

Sugar 7.00 

Proteins 1.50 

Salts 0.20 

Water 87.30 

% 100.00 

COW'S MILK 

Fat % 4.00 

Sugar 4.50 

Proteins 3.50 

Salts 0.75 

Water 87.25 

% 100.00 

Mother's milk is absolutely sterile, that is, free from the 
presence o£ germs; on the other hand, cow's milk is anything 
but sterile — the moment it leaves the udder it begins to accumu- 
late numerous bacteria, all of which multiply very rapidly. 

156 



MILK SANITATION 157 

Cow's milk is generally twenty-four to forty-eight hours old 
before it can possibly reach the baby. It is just as important 
to keep in mind these facts of milk contamination — dirt, filth, 
flies, and bacteria — as it is to plan for the modification of cow's 
milk for the purpose of making it more nearly resemble 
mother's milk. While mother's milk has about the same per- 
centage of fat as cow's milk, it is almost twice as rich in sugar, 
and has only one-fourth to one-third as much protein. This 
protein is vastly different from that found in cow's milk, which 
you recall has a tough curd, as seen in cottage cheese. While 
mother's milk contains a small amount of casein similar to that 
found in the cheese of the cow's milk, the principal protein 
constituent is of another kind (lactalbumin), and is much more 
easy of digestion than the casein of cow's milk. 

This is a most important point to remember, because the 
baby's stomach is not at first adapted to the digestion of the 
heavier and tougher protein curds of cow's milk. It requires 
time to accustom the infant stomach to perform this heavier 
work of digestion. There are a number of factors which must 
be borne in mind in the modification of milk, whether it be 
cow's milk, or goat's milk (for many European physicians use 
goat's milk entirely in the artificial feeding of infants) : namely, 
the cleanliness of the milk, the acidity of milk, the difference 
in the curd, the percentage of sugar, and the presence of 
bacteria. 

SUGAR 

In the modification of cow's milk, sugar must be added to 
make up for the sugar which is decreased when the water was 
added to reduce the protein. There are several sorts of sugar 
used in the modification of milk. These sugars are not added 
to sweeten the milk alone, but to furnish a very important 
element needed for the growth of the baby. Sugar is the one 
element which the infant requires in the largest amount. 

Milk sugar is probably most universally used in the modifica- 
tion of milk, but a good grade of milk sugar is somewhat 
expensive, costing from thirty to sixty cents a pound, and this 
places it beyond the reach of many mothers. It is added to 



158 THE MOTHER AND HER CHILD 

the food mixtures in the proportion of one ounce to every 
twenty ounces of food. Cane sugar (table sugar) may also 
be used, but it must be clean and of good quality. It is used 
in rather less quantity than that of milk sugar, usually from 
one-half to one-third of an ounce by measure to each twenty 
ounces of food. Dextri-maltose (malt sugar) is very easy of 
digestion and may be used in the modification of milk. Maltose 
seems to help the children to gain more rapidly in weight than 
when only milk or cane sugar is used. It is also exceedingly 
useful in constipation, as its action is more laxative than any 
of the other sugars ; but it should not be given to children who 
vomit habitually or have loose stools. 

ACIDITY 

Like mother's milk, the cow's milk is neutral as it comes 
from the udder; but, on standing, it quickly changes, soon 
becoming slightly acid, as shown by testing with blue litmus 
paper. In fact, what is known as ordinarily fresh milk, if sub- 
jected to the litmus paper test, always gives an acid reaction. 
This acidity is neutralized by adding lime water to the formula 
in the proportion of one ounce to each twenty-ounce mixture. 
Ordinary baking soda is sometimes prescribed by physicians in 
place of the lime water. In the event of obstinate constipa- 
tion, milk of magnesia is sometimes added to the day's feedings. 

CREAM 

There may be procured in any large city an instrument called 
the cream gauge, which registers approximately (not accur- 
ately) the richness of milk. Some milk, even though rich, 
parts with its cream very slowly; while some poor milk allows 
nearly all the cream quickly to rise to the surface. We know 
of no way for the mother to determine the amount of cream 
(without the cream gauge) except by the color and richness of 
the milk. In cities it is very convenient to send a specimen 
of the milk to the laboratories to be examined by experts, who 
will gladly render a report to both physician and mother. 

The lactometer is a little instrument used to estimate the 
specific gravity of milk. An ordinary urinometer such as used 




Courtesy of Lakewood Farm 




Courtesy of Lakewood Far 



Fig. ii. A Sanitary Dairy 



MILK SANITATION 159 

by physicians in estimating the specific gravity of urine may 
also be used. The specific gravity of cow's milk should not 
register below 1028 or above 1033. 

HERD MILK 

Milk from a single cow is not to be desired for baby's food 
because of its liability to vary from day to day, not to mention 
the danger of the cow's becoming sick. Authorities have 
agreed that herd milk of Holstein or ordinary grade cows is 
best for infant feeding. This mixed-herd milk contains just 
about the proper percentage of fat; whereas, if Jersey milk 
must be used, some of the cream should be taken away. Our 
milk should come from healthy cows which have been tested 
for tuberculosis at least every three months. 

Annatto is sometimes added to milk to increase its richness 
of color. To test for annatto proceed as follows: To a couple 
of tablespoons of milk add a pinch of ordinary baking soda. 
Insert one-half of a strip of filter paper in the milk and allow 
it to remain over night. Annatto will give a distinct orange 
tint to the paper. The commonly used milk preservatives are 
boracic acid, salicylic acid, and formaldehyde, any of which 
may be readily detected by your health officials. 

SANITARY DAIRIES 

In close proximity to most large cities there is usually to be 
found one or more sanitary dairies. It is a joy indeed to visit 
a farm of this kind with its airy stables and concrete floors, 
which are washed with water coming from a hose. The drain- 
age is perfect — all filth is immediately carried off (Fig. 11). 
The cows are known to be free from tuberculosis, actinomycosis 
(lumpy jaw), and foot and mouth disease. The milkmen on 
this farm wear washable clothes at the milking time, and their 
hands are painstakingly cleansed just before the milking hour. 
Previous to the milking the cattle have been curried outside 
the milking room and their udders have received a careful 
washing. The milkman grasps the teat with clean hands, while 
the milk is allowed to flow through several thicknesses of 
sterilized gauze into the sanitary milking pail. This milk is 



160 THE MOTHER AND HER CHILD 

at once poured into sterile bottles, is quickly cooled and shipped 
in ice to the substations where the delivery wagon is waiting. 
In the ideal delivery wagon there are shallow vats of ice in 
which the bottles are placed, thus permitting the milk to reach 
the baby's home having all the while been kept at a temperature 
just above the freezing point. 

And why all this trouble ? Why all this worry over temperature 
and cleanliness? Babies were not so cared for in the days 
of our grandmothers. The old-fashioned way of milking the 
cows with dirty clothes and soiled hands, while cattle were more 
or less covered with manure, with their tails switching millions 
of manure germs into the milking pail, produced a milk laden 
not only with manure germs — the one great cause of infantile 
diarrhea — but also swarming with numerous other mischief 
making microbes. Even tuberculosis, that much dreaded disease 
germ of early infancy, may come from the dairy hands as well 
as from infected cows. 

There used to be many dairymen like the old farmer who, 
when interrogated by the health commissioner concerning the 
cleanliness of his milk, laughed as he reached down into the 
bottom of a pail of yellow milk and grabbing up a handful of 
manure and straw, said : " That's what makes the youngsters 
grow." But it does not make them grow; it often causes them 
to die, and even if they do live, they live in spite of such con- 
taminated food, for the germ which is always found in the 
colon of the cow (coli communis), probably kills more babies 
every year than any other single thing. 

It is possible to reduce the growth of these germs by keeping 
the milk at a very low temperature from the time it leaves the 
cow until the moment it gets to the home refrigerator. Those 
which survive this process of refrigeration may be quickly 
rendered harmless by pasteurizing or sterilizing at the time 
of preparing baby's food. 

In the absence of the modern sanitary dairy, we would suggest 
that the milk supply be improved by giving attention to the 
following: 

The cattle should be tested for tuberculosis every three 
months. The walls of the cowhouse should be whitewashed 



MILK SANITATION 161 

three times a year. The manure should be stored outside the 
barn. The floor of the cowhouse should be sprinkled and swept 
each day. The cattle should be kept clean — curried each day, 
and rubbed off with a damp cloth before milking. The udders 
should be washed before each milking. The milker can wear 
a clean white gown or linen duster which should be washed 
every two days, while his hands should be washed just before 
the milking. The milking pail should be of the covered sanitary 
order. The barn should be screened. 

CERTIFIED MILK 

Immediately after leaving the cow, the milk should be cooled 
to at least 45 F. It should at once be put into bottles that have 
been previously sterilized and then be tightly covered, and 
should be kept in ice water until ready for consumption. No 
matter how carefully the milk is handled, it is infected with 
many bacteria, but if it is quickly cooled, the increase of the 
bacteria is greatly retarded. Under no circumstances buy milk 
from a grocery store out of a large can. Go to your health 
officer and encourage him in his campaign for sanitary dairies 
and certified milk. 

Such milk as we have described under the head of sanitary 
dairies, when it has been tested by the board of health and has 
received the approval of the medical profession, is known as 
" certified milk;" and, although the price is usually fifteen to 
twenty cents a quart, when compared with the cost of baby's 
illness it will prove to be cheaper than the dirty milk which 
sickens and kills the little folks. 

There is no doubt that the increased use of " certified milk " 
has been a great factor in the reduction of deaths from infant 
diarrhea in recent years. 

BOILING THE MILK 

When certified milk cannot be had, it is absolutely dangerous 
to give raw, unboiled, or unpasteurized milk to the baby, par- 
ticularly in warm weather ; for the countless millions of manure 
germs found in each teaspoon of ordinary milk not only dis- 
turbs the baby's digestion, but actually makes him sick, causing 



1 62 THE MOTHER AND HER CHILD 

colic, diarrhea, and cholera infantum. The only way this milk 
can be rendered safe is by cooking it — actually killing the 
bacteria. This process of boiling, however, does not make good 
milk out of bad milk nor clean milk out of that which is dirty, 
it simply renders the milk less dangerous. 

There are two methods of killing bacteria — sterilization and 
pasteurization. By sterilization is meant the process of render- 
ing the milk germ free by heating, by boiling. Many of the 
germs found in milk are comparatively harmless, merely causing 
the souring of milk ; but other microbes are occasionally present 
which cause serious diseases, such as measles, typhoid and 
scarlet fever, diphtheria, tuberculosis, and diarrhea. It is always 
necessary to heat the milk before using in warm weather, and 
during the winter it is also important when infectious or con- 
tagious diseases are prevalent. 

Milk should be sterilized when intended for use on a long 
journey, and may be eaten as late as two or three days after- 
ward. 

To sterilize milk, place it in a well-protected kettle and allow 
to boil for one hour and then rapidly cool. This process renders 
it more constipating, and for some children many of its nutritive 
properties seem to be destroyed, as scurvy is often the result 
of its prolonged use. When a child must subsist upon boiled 
milk for a long period, he should be given the juice of an 
orange each day. Children are not usually strong and normal 
when fed upon milk of this character for indefinite periods. 
All living bacteria (except the spores or eggs) may be destroyed 
by boiling milk for one or two minutes. 

PASTEURIZATION 

When baby is to use the milk within twenty-four hours, 
" pasteurization " is better than boiling as a method of destroy- 
ing microbes. 

There are many pasteurizers on the market which may be 
depended upon, among which are the Walker-Gordon Pasteur- 
izer, and Freeman's Pasteurizer; but in the absence of either 
of these pasteurization may be successfully accomplished by the 
following method: 



MILK SANITATION 163 

On the bottom of a large kettle filled with cold water, place 
an ordinary flatiron stand upon which is put a folded towel. 
On this place the bottle of milk as it comes from the dairyman, 
with the cap of the bottle loosened. The cold water in the 
kettle should come up to within an inch of the top of the bottle 
of milk. Heat this water quickly up to just the boiling point — 
until you see the bubbles beginning to rise to the top. The gas 
is then turned down or the kettle is placed on the back of the 
range and held at this near-boiling point for thirty minutes, 
after which it is taken to the sink and cold water is turned 
into the water in the kettle, until the bottle of milk is thoroughly 
cooled. It is now ready to be made up into the modified food 
for baby. 

Never let pasteurized milk stand in the room, nor put it near 
the ice when warm. It must be cooled rapidly, as described 
above; that is, within fifteen or twenty minutes. 

The " spores " of the milk are not killed by pasteurization 
and they hatch out rapidly unless the milk is kept very cold, 
and, as already stated, it should be used within twenty-four 
hours after pasteurization. 

THE CARE OF BOTTLED MILK 

The certified milk or the ordinary milk that has been delivered 
to your home and is to be used without pasteurization or steril- 
ization, should receive the following care: 

1. It should be placed at once in a portion of the ice box that 
is not used to store such foods as radishes, cabbage, meats or 
any other open dishes of food whose odors would quickly be 
absorbed by the milk. The milk should never be left standing 
on the doorsteps in the sun, for many reasons : the sun heats 
the milk, encourages the growth of bacteria, and a passing cat 
or dog, whose mouth often contains the germs of scarlet fever, 
tonsilitis, and diphtheria, should it be hungry, laps the tops of 
the bottles, particularly in the winter when the cream has 
frozen and is bulging over the edge. 

2. It should never be kept in the warm kitchen, as when 
visiting her sick baby we discovered one young mother doing. 
In answer to my question, she explained ; " Doctor, we do not 



164 THE MOTHER AND HER CHILD 

take ice in the winter time, everything is ice outdoors, so I 
just set the bottle outside the window bringing it in whenever 
I need to give the baby some food. I forget to put it out some- 
times, but really now, does it matter ? " It really matters much, 
for you see, reader, the milk is first freezing then thawing 
and it is rendered entirely unfit for the baby. 

3. Milk should be kept covered and protected from dust and 
flies; it should be kept in glass jars which have been sterilized 
by boiling before being filled, and then placed in the refriger- 
ator. If the milk is sour, or if there is any sediment in the 
bottle, it is unfit for baby's use. 



CHAPTER XVIII 
HOME MODIFICATION OF MILK 

IN a previous chapter it was found from comparing the 
analysis of mother's milk with that of cow's milk, that 
they widely differed in the proteins and sugar. The art of so 
changing cow's milk that it conforms as nearly as is possible 
to mother's milk is known as " modification." Where protein, 
sugar, and fat are given in proper amounts, healthy infants get 
along well; but when either the fats or proteins are given in 
excess, or when the digestion of the child is deranged, there is 
often no end of mischief. 

There are two groups of milk formulas that are useful. First, 
those in which the fats and proteins are about the same, known 
as " whole milk," , or " straight " milk mixtures ; second, those 
in which the, -fats are used in larger proportions than proteins, 
and known as " top milk " — milk taken from the upper part 
of the bottle after the cream has risen. And since the larger 
proportion of babies take the lower fats or " whole milk " 
formulas, and seem to get along better than the babies who 
have the " top milk " formulas, we will first take up the con- 
sideration of the modification of whole milk. 

PREPARATION FOR MODIFICATION 

To begin with, everything that comes in contact with the 
preparation of baby's food must be absolutely clean. The table 
on which the articles are placed, and any towel that comes in 
contact with the articles or the mother's hands, or those of the 
nurse, must be thoroughly scrubbed. 

There is only one way to prepare the utensils that are to be 
used in making the baby's food, and that is to put them in a 
large kettle and allow them to boil hard for fifteen minutes 

165 



1 66 THE MOTHER AND HER CHILD 

just before they are to be used. The articles needed are (Fig. 
12): 

i. As many bottles as there are 10. A bottle of lime water. 

feedings in one day. n. A fine-mesh, aluminum 

2. A nipple for each bottle. strainer. 

3. Waxed paper for each bottle 12. A square of sterile gauze for 

top. straining the food (should 

4. Rubber bands for each be boiled for fifteen min- 

bottle. utes with the utensils). 

5. A two-quart pitcher. 13. One plate, and later a 

6. A long-handled spoon for double boiler (14). 

stirring the food. 15. The sugar. 

7. A tablespoon. 16. The milk. 

8. A fork. 17. Ready for the ice box. 

9. An eight-ounce, graduated 18. Refrigeration. 

measuring glass. 

BOTTLES AND NIPPLES 

There is but one bottle which can be thoroughly washed 
and cleaned, and that is the wide-mouthed bottle. It should 
hold eight ounces and should have the scale in ounces blown 
in the side (Fig. 10). The nipple for this bottle is a large, 
round breast from which projects a short, conical nipple, which 
more nearly resembles the normal breast than do the old-fash- 
ioned nipples so frequently seen on the small-necked nursing 
bottles. There is a great advantage in this, in that the baby 
cannot grasp the nipple full length and thus cause gagging. 
These bottles and nipples are known as the " Hygeia/' and 
have proven to be a great source of comfort to the baby as 
well as to the mother or nurse whose duty it is to keep them 
clean. There are a number of other nursing bottles on the 
market, which, if they are used, must be thoroughly cleansed 
with a special bottle brush each day. The neck is small and 
the nipple is small and great care must be taken in the cleansing 
of both of them. 

CARE OF BOTTLES AND NIPPLES 

When there is a bottle for each individual feeding in the day, 
immediately after each nursing both bottle and nipple should 



HOME MODIFICATION OF MILK 



167 



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168 THE MOTHER AND HER CHILD 

be rinsed in cold water and left standing, filled with water, 
until the. bottles for one day's feeding have all been used. The 
nipples should be scrubbed, rinsed, and wiped dry and kept by 
themselves until their boiling preparation for the following 
day's feeding. 

If the same bottle is to be used for the successive feed- 
ings during the day, it should be rinsed, washed with soap and 
water, and both bottle and nipple placed in cold water and 
brought quickly to the boiling point and allowed to boil for 
fifteen minutes. No bottles or nipples must ever be used after 
a mere rinsing; boiling, preceded by a thorough washing in 
soap and water, must take place before they are used a second 
time. 

New nipples are often hard and need to be softened, which is 
readily done by either prolonged boiling or rubbing them in 
the hands. 

All new bottles should be annealed by placing them on the 
stove in a dishpan of cold water and allowing them to boil 
for twenty minutes, and then allowing them to remain in the 
water until they are cold. When bottles are treated in this 
manner they do not break so readily when being filled with 
boiling water or hot food. 

PREPARING THE FOOD 

In a large preserving kettle place all the utensils needed in 
the preparation of the food — pitcher, spoon, fork, measuring 
glass, bottles, nipples, cheesecloth for straining, agate cup, wire 
strainer, in fact everything that is to be used in the preparation 
of the food. Now fill the kettle with cold water and place over 
the gas and allow to boil for fifteen minutes. On a well- 
scrubbed worktable place a clean dish towel, and on this put the 
utensils and the bottles right side up. The nipples on being 
taken out of the boiling water will dry of themselves; they 
should be placed in a glass-covered jar until they are needed 
for each individual feeding, the nipples not being placed on the 
bottles as they go to the ice box. 

Having been given your formula by your physician, proceed 
in the following way. Suppose we were preparing the food 



HOME MODIFICATION OF MILK 169 

for a normal two-months old baby that weighed ten pounds, 
with the prescription as follows: 

Baby Smith. 
$ 

Whole Milk ounces 11 

Cane Sugar level tablespoons 2 

Boiled Water ounces 12^2 

Lime Water ounces 1 

Amount at Each Feeding ounces 3^ 

Number of Bottles 7 

Interval Between Feedings hours 3 

DETAILS OF PREPARATION 

Two level tablespoons of cane sugar are placed in the agate 
cup and dissolved in a small amount of boiling water. The 
solution should be perfectly clear, and if it does not clear up 
put it over the heat for a few moments. 

This is now turned into the eight-ounce measuring glass 
which is then filled with boiling water and emptied into the 
two-quart pitcher. We need four and one-half more ounces of 
boiling water to complete the prescription requirement of twelve 
and one-half ounces. 

The bottle of milk, if properly certified, need not be pasteur- 
ized; but if it is not, it should have been previously pasteurized 
while the utensils were boiling according to the suggestions 
found in the chapter on " milk sanitation." The top of the 
milk bottle should be thoroughly rinsed and wiped dry, and 
after a thorough shaking of the milk, the cover is removed with 
the sterile fork and eleven ounces are measured out by measur- 
ing glass and poured into the pitcher. All is now stirred 
together with an ounce of lime water, which should never look 
murky, but should be as clear as the clearest water and should 
always be kept in the ice box when not in use. 

The sterile cheesecloth which has been boiled for fifteen 
minutes is now put over the nose of the pitcher, the contents 
of which is accurately measured into the seven clean, empty 
bottles, each containing three and one-half ounces. Over the 



top of each of the nursing bottles is placed a generous piece of 



170 THE MOTHER AND HER CHILD 

waxed paper which is held down by a rubber band. Each meal 
for the day is now contained in a separate bottle, and all are 
placed in a covered pail of water containing ice, and put in the 
ice box. 

If the prescription for the baby's food contains gruel, it is pre- 
pared in the following manner: 

Suppose the baby is eight months old and the prescription 
called for two level tablespoons of flour and eight ounces of 
boiled water. The two level tablespoons of flour, whether it 
be wheat (ordinary bread flour), or barley flour, are put into 
a cup and stirred up with cold water, just as you would stir up 
a thickening for gravy; now measure out eight ounces of water 
and allow it to come to a boil in the inner pan of the double 
boiler, into which the thin paste is stirred until it comes to a 
boil. After boiling for twenty minutes, remeasure in the measur- 
ing glass and what water has been lost by evaporation must be 
added to complete accurately the prescription requirement of 
eight ounces; this is now added to the other ingredients of the 
prescription. 

TABLE FOR INFANT FEEDING 

We now offer a monthly schedule — a table which is the 
result of our experience in feeding hundreds of babies in vari- 
ous sections of Chicago. It is not a schedule for the sick baby, 
but it is a carefully tabulated outline for the normal, healthy, 
average child ranging from one week to one year in age. In 
offering this table we remind the mother, if the baby is six 
months old and not doing well on the food it is getting and a 
change is desired by both mother and physician, that it is far 
better to begin with the second or third month's prescription 
and quickly work up to the sixth month's. This change may 
often be accomplished in two or three days. 

In all large cities there are to be found milk laboratories 
which make it their business to fill prescriptions for the modi- 
fication of milk under the direction of baby specialists. This 
milk can be absolutely relied upon. In specialized diet kitchens 
in many large hospitals, these feeding prescriptions also may 
be filled. 



HOME MODIFICATION OF MILK 



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172 THE MOTHER AND HER CHILD 

TOP-MILK FORMULA 

Top milk is the upper layer of milk which has been removed 
after standing a certain number of hours in a milk bottle or any- 
other tall vessel with straight sides. It contains most of the 
cream and varying amounts of milk. It may be removed by a 
small cream dipper which holds one ounce, or it may be taken 
off with a siphon, but it should never be poured off. To obtain 
seven per cent top milk which is the one most ordinarily used in 
the preparation of top milk formulas, we take off varying 
amounts — according to the quality of the milk — which Doctor 
Holt describes as follows: 

From a rather poor milk, by removing the upper eleven ounces 
from a quart, or about one-third the bottle. 

From a good average milk, by removing the upper sixteen ounces, 
or one-half the bottle. 

From a rich Jersey milk, by removing the upper twenty-two 
ounces, or about two-thirds the bottle. 

Cream is often spoken of as if it were the fat in milk. It 
is really the part of the milk which contains most of the fat 
and is obtained by skimming, after the milk has stood usually 
for twenty- four hours; this is known as "gravity cream." It 
is also obtained by an apparatus called a separator; this is 
known as " centrifugal cream," most of the cream now sold 
in cities being of this kind. The richness of any cream is indi- 
cated by the amount of fat it contains. 

The usual gravity cream sold has from sixteen to twenty 
per cent fat. The cream removed from the upper part (one- 
fifth) of a bottle of milk has about sixteen per cent fat. The 
usual centrifugal cream has eighteen to twenty per cent fat. 
The heavy centrifugal cream has thirty-five to forty per cent 
fat. 

The digestibility of cream depends much upon circumstances. 
Many serious disturbances of digestion are caused by cream. 

It is convenient in calculation to make up twenty ounces of 
food at a time. The first step is to obtain the seven per cent 
milk, then to take the number of ounces that are called for 
in the formula desired. 



HOME MODIFICATION OF MILK 173 

One should not make the mistake of taking from the top of 
the bottle only the number of ounces needed in the formula, as 
this may be quite a different per cent of cream and give quite a 
different result. 

There will be required in addition, one ounce of milk sugar 
and one ounce of lime water in each twenty ounces. The rest 
of the food will be made up of boiled water. 

These formulas written out would be as follows: 

FORMULA FROM SEVEN PER CENT MILK 

I II III IV V VI VII VIII IX 

Oz. Oz. Oz. Oz. Oz. Oz. Oz. Oz. Oz. 

7 per cent milk 2 3 456789 10 

Milk sugar 1 1 1 1 1 % % % % 

Lime water 1 1 1 1 1 1 1 1 1 

Boiled water 17 16 15 14 13 12 11 10 9 

~20 "20 ~20 ""20 ~20 ~20 ~20 ~~20 ~20 

The approximate composition of these formulas expressed in 
percentages are as follows: 

Formula Fat Sugar Proteins 

I 0.70 5.00 0.35 

II 1.00 6.00 0.50 

III 1.40 6.00 0.70 

IV 1.75 6.00 0.87 

V 2.00 6.00 1.00 

VI 2.40 6.00 1.20 

VII 2.80 6.00 1.40 

VIII 3.10 6.00 1.55 

IX 3.50 6.00 1.75 

It is necessary to make the food weak at first because the infant's 
stomach is intended to digest breast milk, not cow's milk; but if we 
begin with a very weak cow's milk the stomach can be gradually 
trained to digest it. If we began with a strong milk the digestion 
might be seriously upset. 

Usually we begin with number one on the second day; num- 
ber two on the fourth day; number three at seven to ten days; 
but after that make the increase more slowly. A large infant 
with a strong digestion will bear a rather rapid increase and 
may be able to take number five by the time it is three or four 
weeks old. A child with a feeble digestion must go much 



174 THE MOTHER AND HER CHILD 

slower and may not reach number five before it is three or 
four months old. 

It is important with all children that the increase in the food be 
made very gradually. It may be best with many infants to increase 
the milk by only half an ounce in twenty ounces of food, instead of 
one ounce at a time, as indicated in the tables. Thus, from three 
ounces the increase would be to three and one-half ounces; from 
four ounces to four and one-half ounces, etc. At least two or three 
days should be allowed between each increase in the strength of 
the food. 

PEPTONIZED MILK 

Another modification which at times may be ordered by your 
physician is peptonized milk. Since it is infrequent for the 
proteins of milk to be the cause of indigestion, peptonized milk 
has only a limited use, chiefly in cases of acute illness. The milk 
is peptonized in the following manner : 

Place the peptonizing powder (it is procurable in tubes or 
tablets from the drug store) in a small amount of milk, and 
after being well dissolved, put into the bottle or pitcher with the 
plain or modified milk, after which the whole is shaken up 
together. The bottle is then put into a large pitcher containing 
water heated to about no° F. or as warm as would bear the 
hand comfortably, and left for ten or twenty minutes (if the 
milk is to be partially peptonized). To completely peptonize the 
milk, two hours are required. Either of these formulas is only 
used on the advice of a physician. 

BUTTERMILK 

In many cases of chronic intestinal indigestion, buttermilk 
is used in place of the milk. It is prepared as follows: After 
the cream has been taken from the milk and it has been allowed 
to come to a boil, it is cooled to just blood heat. A buttermilk 
tablet, having first been dissolved in a teaspoonful of sterile 
water, is now stirred into the quart of warmed, skimmed milk 
and allowed to stand at room temperature for twenty-four hours 
at which time it should look like a smooth custard. With a 
sterile whip this is now beaten and is ready for the sugar and 



HOME MODIFICATION OF MILK 175 

the boiled water which is added according to the written pre- 
scription from the doctor. 

CONDENSED MILK 

Under no circumstances should condensed milk be used as 
the sole food of the baby for more than one month. Children 
often gain upon it, but as a rule they have little resistance, and 
they are very prone to develop rickets and oftentimes scurvy; 
and, as noted elsewhere, orange juice should always be adminis- 
tered at least once during the twenty-four hours as long as 
condensed milk is used. 

Of all the brands of condensed milk, those only should be 
selected which contain little or no cane sugar. Perhaps the 
" Peerless Brand " of evaporated milk is the most reliable and 
in the preparation of food from this evaporated milk the same 
amount of sugar, etc., should be added as we do in the prepara- 
tion of " whole milk " or " top milk." 

We do not in any way advise the use of condensed milk. 
Fresh milk should always be used where it is obtainable, but 
in traveling it sometimes has to be used. Holt says, " It should 
be diluted twelve times for an infant under one month and six 
to ten times for those who are older." 

Malted milk is a preparation suitable in some cases where 
fresh cow's milk is not obtainable. Even better than condensed 
milk, this food will be found serviceable in traveling, or in 
instances where only very bad cow's milk is within reach. 

SPECIAL FOODS 

Most patent foods are made up of starches and various kinds 
of sugars, and some of them have dried milk or dried egg 
albumin added. Many flours under fanciful names are sold on 
the market today. For instance, one flour with a very fanciful 
name is simply the old fashioned " flour ball " that our great, 
great grandmothers made; and, by the way, perhaps there is 
no flour for which we are more grateful in the preparation of 
infant food than the flour ball which is prepared as follows : 
A pound of flour is tied tightly in a cheesecloth and is put into 
a kettle of boiling water which continues to boil for five or six 



176 THE MOTHER AND HER CHILD 

hours, at the end of which time the cheesecloth is removed and 
the hard ball, possibly the size of an orange, is placed on a pie 
pan and allowed slowly to dry out in a low temperatured oven. 
At the end of two or three hours, the ball, having sufficiently 
dried, has formed itself into a thick outer peel which is removed, 
while the heart which is very hard and thoroughly dry, is now 
grated on a clean grater, and this flour has perhaps helped more 
specialists to serve more sick babies than any other form of 
starch known. It is used just as any other flour is used — wet 
up into a paste, made into a gruel, which is boiled for twenty 
minutes before it is added to the milk. 

Whey is sometimes used in the preparation of sick babies' 
food and is prepared as follows: 

To a pint of fresh lukewarm cow's milk are added two tea- 
spoons of essence of pepsin, liquid rennet or a junket tablet. It is 
stirred for a moment, then allowed to stand until firmly coagulated, 
which is then broken up and the whey strained off through a 
muslin. 

The heavy proteins remain in the curd, and the protein that 
goes through with the whey is chiefly the lactalbumin. 

h 

1 



CHAPTER XIX 
THE FEEDING PROBLEM 

A FRIEND of ours who presides over a court of domestic 
relations in a large city, recently told us that he believed 
much trouble was caused in families — many divorces, occa- 
sioned, and many desertions provoked — because improperly fed 
babies were cross and irritable and so completely occupied the 
time of the mother, who, herself, knew nothing about mother- 
craft or the art of infant feeding. Consequently, the home was 
neglected and unhappy, quarreling abounded and failure, utter 
failure, resulted. The children were constantly cross, and so 
much of the mother's time was consumed in caring for these 
irritable, half-fed babies, that the home was disheveled, the 
meals never ready, the husband's home-coming was a dreaded 
occurrence, and he, endeavoring to ;seek rest and relaxation, 
usually sought for it in the poolroom or the saloon, with the 
usual climax which never fails to bring the time-honored results 
of debauch — despair and desertion. 

In the beginning of this book we paid our respects to the 
present-day educational system which does not provide an 
adequate compulsory course in which all women could be given 
at least a working knowledge of home-making and the care 
and feeding of the babies; so that statement need not be 
repeated in this chapter. But we wish to add, in passing, that 
ignorance is the basis and the foundation of more unhappy 
homes, broken promises, panicky divorces, and shattered hopes, 
as well as of more deaths during the first year of infancy, than 
any other cause. And in speaking of its relationship to baby- 
craft, we believe that ignorance concerning normal stools, how 
many times a day the bowels should move; how much a baby's 
stomach holds ; how often he should be fed, etc. — I say it is 

177 



178 THE MOTHER AND HER CHILD 

ignorance of these essential details that lies at the bottom of 
many problems which come up during the first year, par- 
ticularly the " feeding problem." 

INFANT WELFARE 

In the city of Chicago at the time of this writing, the Infant 
Welfare Association maintains over twenty separate stations 
where meetings are held for mothers, where lectures are deliv- 
ered on the care and feeding of babies. Babies are brought 
to these stations week in and week out; they are weighed and 
measured and, if bottle-fed, nurses are sent to the homes to 
teach the mother how properly to modify the milk in accord- 
ance with the physician's orders. The health authorities of our 
city also maintain several such stations where mothers and 
babies may have this efficient help. A corps of nurses are 
employed to carry out the instructions and to follow up the 
mothers and the babies in their homes, and thus the death rate 
has been greatly reduced, not only in our city but in all such 
cities where baby stations have been instituted. In a certain 
ward in Philadelphia the death rate was reduced forty-four 
per cent in one year after the baby stations were established. 

CHOOSING A FORMULA 

There are three classes of infants who require weak-milk 
mixtures to begin with : namely, the baby who has been previ- 
ously nursed and whose mother's milk has utterly failed; the 
baby just weaned; and the infant whose power to digest is low. 
If these children were six months old, and the formula best 
suited to them is unknown, we must begin with a formula 
suited to a two- or three-month-old child and quickly work up 
to the six-month formula, which may often be accomplished 
within two or three days. 

THE BOTTLE-FED BABY 

When a baby is getting on well with his food, he should 
show the following characteristics : He should have a good 
appetite; should have no vomiting or gas; he should cry but 
little; and he should sleep quietly and restfully. His bowels 



THE FEEDING PROBLEM 179 

.should move once or twice in twenty-four hours. His stool 
should be a pasty homogeneous mass. He should possess a clear 
skin and good color. He should show some gain each week — 
from four to eight ounces — and he should also show mental 
development. 

As long as a baby appears happy and gains from four to 
eight ounces a week and seems comfortable and well satisfied, 
the feeding mixture should not be changed or increased. 

MAKE CHANGES GRADUALLY 

In our experience with the artificial feeding of infants, we 
have come to look upon the practice of gradually changing the 
food formula as the most important element in successful baby 
feeding. 

We recall one mother in the suburbs who came to us with 
her baby who had been feeding on a certain proprietary food. 
She declared that it " just couldn't take cow's milk." She 
admitted " it was not doing well/' and so she would like to 
have help. The baby was old enough, had it been normal, to 
have been taking whole milk for some time. We recall our 
having the mother prepare the proprietary food just as she had 
been used to preparing it, and each day we had her throw 
away one-half ounce and put in one-half ounce of whole milk, 
this mixture she fed the baby for two days. 

The next time, we had her take out one ounce of the mixture 
and put in one ounce of whole milk, which we fed the baby 
for three successive days; and then one and one-half ounces 
were substituted which was fed to the baby for four days; and 
thus we carefully, slowly, and gradually withdrew the proprie- 
tary food and substituted fresh, certified cow's milk. It took 
us a month to complete the change, but we are glad to add that 
it was done without in the least disturbing the child. 

Now, had the change been made abruptly — in a day or two, 
or three days — the baby would probably have been completely 
upset, while both the mother and the doctor would have been 
greatly discouraged. Many mothers and even some physicians 
have jumped from one baby food to another baby food; they 
have tried this and they have tried that, until the poor child. 



180 THE MOTHER AND HER CHILD 

having been the victim of a number of such dietetic experi- 
ments, finally succumbed. 

We cannot urge too strongly the fact that, as a rule, when- 
ever a change is made from one food to another, it should be 
done gradually, unless it be the change of a single element 
such as that of a very high per cent of cream found in top 
milk mixtures, when it seems to be a troublesome element in 
the milk. No bad effects will follow the quick change to 
skimmed milk with added sugar, starches, etc.; but in changing 
from a proprietary food to a milk mixture, the change should 
always be made gradually, the quantity of the new food being 
increased gradually. Milk should be increased by quarter (34 ) 
ounce additions, and it should not be increased more than one 
ounce in one week; while the mixture should not be increased 
as long as the baby is gaining satisfactorily. A wise mother 
and an experienced physician can usually see at a glance when 
a child is doing well — by the color and consistency of the stools, 
the child's appetite, his sleep, and his general disposition. 

COMMON MISTAKES IN FORMULAS 

First and foremost, we believe a great mistake is often made 
in using too heavy cream mixtures; babies as a rule do not 
stand the use of too high a percentage of cream. Formulas 
that call for whole milk should contain four per cent fat or 
cream; and while babies often gain rapidly on the higher per- 
centage of cream found in a rich Jersey milk, nevertheless, 
sooner or later serious disturbances of digestion usually occur. 
Herd milk is, therefore, better for the babies because in the 
" whole milk " of the herd of Holsteins we have only about 
four per cent fat. 

Another common mistake is too heavy feeding at the time of 
an attack of indigestion ; even, the usual feeding may be too 
heavy during this time of indisposition. It is not at all uncom- 
mon for us to dilute baby's food to one-third its strength at 
the time of an acute illness. 

Still another trouble maker is dirt — dirt on the dish-towel, 
dirt on the nipple, dirt in the milk, dirt on the mother's hands. 
Dirt is an ever present evil and an endless trouble maker, as 



THE FEEDING PROBLEM 181 

evidenced by stool disturbances, indigestion, fretful days, and 
sleepless nights. A dirty refrigerator is another factor which 
has been responsible for much illness and distress. 

Indigestion is often brought on because a nurse, caretaker, 
or possibly the mother, not wishing to go down to the refriger- 
ator in the middle of the night, brings up the food early in 
the evening and allows it to become warm — to remain in a 
thermos bottle — and we are sure that had they been able to 
see the enormous multiplication of germs because of this warm 
temperature, they would never have given occasion for such 
an increase in bacteria just to save themselves a trifle of incon- 
venience. 

Still another common mistake is to use one formula too long; 
a feeding mixture which was good for four or possibly six 
weeks, must be changed as the child grows older and his 
requirements become greater. Let the weight, stools, general 
disposition and sleep of the child be your guides, and with 
these in mind errors in feeding can be quickly detected and 
minor mistakes speedily rectified. 

SYMPTOMS OF DISSATISFACTION 

Some of the pointed questions which are put to a young 
mother who brings her child into the office of the baby specialist, 
are the following: 

Does the baby seem satisfied after his feeding? 

Does he suck his fist? 

How much does he gain each week in weight? 

Does he sleep well? 

Does the baby vomit? 

What do his bowel movements look like? 

Will you please send a stool to the office? 

With the intelligent answers to these questions — after know- 
ing the birth weight and the age of the child and its general 
nervous disposition — the physician can formulate some con- 
clusion as to the babe's general condition and can usually 
find a feeding formula that will make him grow. 

Vomiting, restlessness, sleeplessness and the condition of the 



182 THE MOTHER AND HER CHILD 

bowels, are the telltales which indicate whether or not the food 
is being assimilated; and the stools may vary all the way from 
hard bullet-like lumps to a green diarrhea. 

Babies do not thrive well in large institutions where the 
food is so often made up in a wholesale manner, for the simple 
reason that the food elements are not suited to the need of 
each individual baby. Some infants are unable to digest raw 
milk, and for them sterilized or boiled milk should be tried; 
others require a fat-free mixture such as skimmed milk, while 
still others may need buttermilk for a short time. Babies 
require individual care, particularly in their food, and the good 
or bad results are plainly shown in the stools, weight, sleep, etc. 

FLATULENCE 

Flatulence is an excessive formation of gas in the stomach 
and bowels leading to distension of the abdomen and the belch- 
ing of gas, and often the bringing up of a sour, pungent, watery 
fluid. 

Flatulence is seen in infants suffering from intestinal indi- 
gestion and the food is nearly always at fault. This condition 
is the result of the faulty digestion of the sugar and starches 
— particularly the starch — which should be immediately 
reduced. In such conditions the addition of a slight amount 
of some alkaline (such as soda, magnesia or lime water) to 
the food often produces good results. Great patience must be 
exercised with a child that suffers from flatulence, for immediate 
improvement can hardly be expected; time is required for the 
restoration of good digestion. 

VOMITING 

Vomiting is perhaps more often the result of over feeding or 
too frequent feeding than anything else. A healthy, breast-fed 
baby may now and then regurgitate a bit, but it simply spills 
over because it is too full. We do not refer to this as vomiting, 
we refer to the belching up or vomiting of very sour or acrid 
milk which leaves a sour odor on the clothing. This can all 
usually be rectified by lengthening the intervals from two to 
three hours and preventing bolting of food by getting a nipple 



THE FEEDING PROBLEM 183 

whose hole is not so large. Too much cream in the food will 
also sometimes cause vomiting. 

Too frequent feeding at night is another cause of vomiting. 
When the stomach is full, the failure to lay the baby down 
quietly, as is so often seen in those homes where bouncing and 
jolting are practiced, may also result in vomiting. 

Vomiting may be the first sign of many acute illnesses such 
as scarlet fever, measles, pneumonia, whooping cough, etc. 

The treatment for acute vomiting is simple. All foods should 
be withheld — nothing but plain, sweetened water should be 
administered, while it is often advisable to give a dose of 
castor oil. A physician should be called at once if the vomit- 
ing continues, and not until the vomiting has entirely ceased 
for a number of hours and water is easily retained, should food 
be given, and even then it should be begun on very weak 
mixtures. 

OVER-FEEDING 

The size of the child's stomach should be the guide to the 
quantity of food given, and attention is called to the table 
given in a previous chapter. All food taken in excess of his 
needs lies in his stomach and intestines only to ferment and 
cause wind and colic. The symptoms of over-feeding are rest- 
lessness, sleeplessness, stationary weight (or loss in weight), 
and oftentimes these very symptoms are interpreted by the 
mother as sufficient evidence that the baby needs more food; 
and so the reader can see the terrible havoc which is soon 
wrought where such ignorance reigns. 

WEIGHT 

The weighing time should immediately follow a bowel move- 
ment and just before a feeding time; then, and only then, 
we have the real weight of baby, as a retained bowel movement 
may often add from four to five ounces to the child's weight. 
There should be a careful record of each weighing, for there 
may develop a great difference if different members of the 
family endeavor to keep the weight in their minds. The normal 
baby should gain four to eight ounces a week up to six months, 



184 THE MOTHER AND HER CHILD 

and from then on the weekly gain is from two to four ounces; 
in other words, by six months the baby should double his birth 
weight and at the end of a year his weight should be three 
times the birth weight. A stationary or diminishing weight 
demands careful attention; a good doctor should be called at 
once. Likewise, a very rapid increase in weight is not to be 
desired, as we do not want a fat baby, but we do desire a well- 
proportioned and alert baby, and, as someone has said, it is 
better to have little or no gain during the excessive heat than 
to upset the digestion by over-feeding, designed to keep the 
baby gaining. 

In weighing, usually the outside garments are removed, 
leaving on a shirt, band, diaper, and stockings with the neces- 
sary pins; the little fellow thus protected is placed into the 
weighing basket and at each successive weighing, these same 
clothes or others just like them are always included in the 
weight, and it should be so reported to the physician. 

THE STOOLS 

In the chapter " Baby's Early Care," the first stools were 
described in detail, and there we learned that the dark, tarry, 
meconium stools are quickly changed within a week to the 
normal canary-yellow stool, having the odor of sour milk. 

The bottle-fed babies' stools differ somewhat in appearance; 
they are thicker and a lighter color, but should always be 
homogeneous if the food is well digested. They do not have 
nearly the number of bowel movements each day that the 
breast-fed baby does. If a bottle-fed baby's bowels move once 
a day and he seems perfectly well otherwise, we are satisfied. 
And curds (white lumps), or mucus (sedimentary, slimy 
phlegm), indicate that the food is not well digested. 

BOTTLE FEEDING AND CONSTIPATION 

A bottle baby may be constipated because the proteins are 
too high, the fat too high, the food of an insufficient quantity 
or quality, or the milk have been boiled, while weak babies 
really may lack the muscular power to produce a bowel move- 
ment. With the help of your physician endeavor to arrive 



THE FEEDING PROBLEM 185 

at the cause of the constipation, and, if the baby is two or 
three months old, from one to two teaspoons of unsweetened 
prune juice may be administered. Milk of magnesia may be 
added to the food (leaving out the lime water), or a gluten 
suppository may be used. 

The change from milk sugar to malt sugar has helped many 
infants; while the giving of orange juice (after six months) is 
very beneficial in many cases. A small amount of sweet oil may 
be injected into the rectum which will lubricate the hard lumps 
and thus favor comfortable evacuation. The periodicity of the 
bowel movement (at definite times each day) is a matter of 
great importance. Immediately after a meal, if the child is 
old enough, he should be placed on the toilet chair. A bit of 
cotton, well anointed with vaseline and inserted into the rectum 
just before meals, will often aid in producing a bowel move- 
ment shortly after the meal has been taken. 

Abdominal massage should be administered in all instances 
of constipation, beginning with light movements and gradually 
increasing, with well-oiled hands. 

DIARRHOEA 

Diarrhoea usually accompanies acute intestinal indigestion and 
is so often associated with the common disorders of infancy 
that we refer the reader to the chapter " Common Disorders 
of Infancy." Dark stools should always be saved for the 
physician to observe, as they frequently contain blood. Stools 
full of air bubbles with pungent sour odor show fermentation ; 
in which cases the starches should be reduced, if not entirely 
taken away from the food mixtures. Green stools mean putre- 
faction from filth-germs; a thorough cleansing of the bowel 
should be immediately followed by a reduction in the strength 
of the food and the boiling of the milk. 

REGULATION OF THE STOOLS 

At a certain time each day the napkin should be removed 
and the child should be held out over a small jar. It is sur- 
prising to note how quickly and readily the little fellow co- 
operates. Diaper experiences may be limited to much less than 



186 THE MOTHER AND HER CHILD 

a year if the mother has patience enough and the baby has the 
normal intelligence to enter into this regulation regime. We 
recall one caretaker who complained bitterly because the child 
under her care constantly wet his diaper; so the caretaker 
was instructed to keep a daily schedule of the baby's actions 
for five days ; and, to her surprise, she discovered that the 
baby urinated about the same time each day. A regularity 
was also noted concerning the bowel movements. 

The variations in the time of the urinations were only 
fifteen or twenty minutes, so nearly did the kidneys act at 
the same time each day. The caretaker was instructed to remove 
the diaper and hold the baby out at the earliest occurrence on 
the daily schedule, and, to the astonishment of the entire 
family, no further accidents occurred, and the child soon ac- 
quired the habit of letting them understand when he was about 
to wet his diaper. Bowel movements may be regulated more 
easily than the urination. After the child is about a year old, 
very few accidents should occur. 

MIXED FEEDING 

In many instances, and particularly if the infant is under 
six months of age, and where he has had to have additional 
feeding from the bottle — under such circumstances the breast 
milk may be continued as " partial feeding," at least until the 
baby has reached his ninth or tenth month, at which time it 
may be wholly discontinued. 

At each nursing time the baby empties both breasts, and 
the amount he draws may readily be estimated by carefully 
weighing him before and after each nursing. By referring 
to the directions in a previous chapter, the quantity of food 
needed for his size and age may be determined ; while the deficit 
is made up from a bottle of milk containing properly modified 
cow's milk. 

If the mother's health admits, or if the breasts continue to 
secrete a partial meal for the babe, mixed feeding should be 
continued until after the ninth or tenth month, when it can 
gradually be reduced from four or five times each day to once 
or twice a day, until it is finally omitted altogether. In the 



THE FEEDING PROBLEM 187 

meantime, the baby is gradually getting stronger food and at 
eleven or twelve months the little fellow is able to subsist and 
thrive upon whole milk. 

INFANT FEEDING PUZZLES 

It is very difficult to explain how some babies thrive on some 
certain food while others grow thin and speedily go into a decline 
on the same regime. The hereditary tendencies and predisposi- 
tions undoubtedly have a great deal to do with such puzzling 
cases. 

Again, sometimes a slight variation in technic or some other 
trifling error in connection with the preparation of the 
baby's food, may be more or less responsible for the varia- 
tion in the results obtained. No two mothers will prepare food 
exactly alike even when both are following the same printed 
directions and these slight discrepancies are enough to upset 
some delicately balanced baby. 

On the other hand, some babies are born with such strong 
digestive powers and such a powerful constitution that they are 
easily able to survive almost any and all blunders as regards 
artificial feeding, while at the same time they also manifest the 
ability to surmount a score of other obstacles which the com- 
bined ignorance and carelessness of their parents or caretakers 
unknowingly place in the pathway of early life which these little 
folks must tread. 

The fact that so many babies do so well on such unscientific 
feeding only serves to demonstrate the old law of " the survival 
of the fittest " — they are born in the world with an enormous 
endowment of " survival qualities " — and in many cases the 
little fellows thrive and grow no matter how atrociously they 
are fed. 

There may be other factors in the explanation of why some 
babies do so well on such poor care, but heredity is the chief 
explanation, while adaptation is the other. If the little fellows 
can survive for a few weeks or a few months, the human 
machine possesses marvelous powers of adaptation, and we 
find here the explanation why many a neglected baby pulls 
through. 



188 THE MOTHER AND HER CHILD 

INFANT FOODS 

Rickets and scurvy have so often followed the prolonged use 
of the so-called " infant foods " which have flooded the market 
for the past decade, that intelligent physicians unanimously 
agree that they are injurious and quite unfit for continued use in 
the feeding of infants. If they are prescribed to replace milk 
during an acute illness, or at other times when the fats and 
proteins should be withheld for a short period, both the 
physician and the mother should be in the possession of definite 
and exact knowledge as to just what they do and do not con- 
tain. To provide such knowledge, we present the analysis 
(Holt) of some of the more commonly used infant foods. 

1. The Milk Foods. Nestle's Food is perhaps the most widely 
known. The others closely resembling it in composition are 
the Anglo-Swiss, the Franco-Swiss, the American-Swiss, and 
Gerber's Food. These foods are essentially sweetened, con- 
densed milk evaporated to dryness, with the addition of some 
form of flour which has been dextrinized; they all contain a 
large proportion of unchanged starch. 

2. The Liebig or Malted Foods. Mellin's Food may be taken 
as a type of the class. Others which resemble it more or less 
closely are Liebig's, Horlick's Food, Hawley's Food, malted 
milk, and cereal milk. Mellin's food is composed principally 
(eighty per cent) of soluble carbohydrates. They are derived 
from malted wheat and barley flour, and are composed chiefly 
of a mixture of dextrins, dextrose, and maltose. 

3. The Farinaceous Foods. These are Imperial Granum, 
Ridge's Food, Hubbell's Prepared Wheat, and Robinson's Patent 
Barley. The first consists of wheat flour previously prepared 
by baking, by which a small proportion of the starch — from 
one to six per cent — has been converted into sugar. 

In chemical composition these four foods are very similar to 
each other, consisting mainly of unchanged starch which forms 
from seventy-five to eighty per cent of their solid constituents. 

4. Miscellaneous Foods. Under this head may be mentioned 
Carnrick's Soluble Food and Eskay's Food. 

The composition of the foods mentioned is given in the accom- 
panying table. 



THE FEEDING PROBLEM 



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CHAPTER XX 
BABY'S BATH AND TOILET 

FROM earliest girlhood, women have loved their dolls, and 
one of the greatest joys connected with the adored expe- 
rience was the make-believe bath and the dressing of the make- 
believe baby ; so now, when we are the happy possessors of real 
live dolls, we should go about the task with the same light- 
headedness of a score of years ago when we hugged, kissed, 
bathed, and dressed our dolls. There is one big advantage now, 
the doll won't break; but, we sigh as we stop to think, we can't 
stick pins into it as we all did into the sawdust bodies of our 
dolls those years and years ago. 

THE FIRST WEEK 

In the chapter on " Baby's Early Care," this subject was 
fully discussed and we only wish to repeat, in passing, that 
before baby's bath or toilet is undertaken the hands of the 
mother, nurse, or caretaker must be scrupulously clean. And 
while the first day's bath usually consists of sweet oil, albolene, 
or benzoated lard, if the new baby happens to come during the 
very warm days of July or August and the oil seems to irritate 
the soft downy skin, as it often does during those hot days, a 
simple sponge bath may be substituted. The cord dressing 
remains as the doctor left it, and if there be any interference, 
let it be subject to his orders. 

The cord usually drops off, and the abdomen is entirely healed 
by the seventh to the tenth day, after which time baby is daily 
sponged for another week. And now we will describe in detail 
the simplest, easiest manner of administering an oil bath or a 
sponge bath. 

190 



BABY'S BATH AND TOILET 191 

GIVING THE BATH 

A large pillow or a folded soft comfort is placed on a table 
in a warm room — temperature not below 75 F. On baby's 
tray near by, and within reaching distance, are the boracic acid 
solution in a small cup, a medicine dropper, the warm saucer 
of oil, the toothpick applicators (made by twisting cotton about 
one end, making sure the sharp end of the pick is well pro- 
tected), a glass jar of small cotton balls made from sterile 
absorbent cotton, the castile soap, talcum powder, needle and 
thread. A vessel of warm water, several old, soft, warmed 
towels and the clean garments required, complete the layout. 

Into the warm, soft blanket on the pillow or comfort we 
place the partially undressed baby, for the binder, diaper, and 
socks are not removed until the head-and-face toilet is com- 
pleted. 

The top of the head, behind the ears, the folds of the neck, 
and the armpits are now gently but thoroughly rubbed with 
oil, which is then all rubbed off with a soft linen towel. The 
eyes next receive two or three drops of the boracic acid solu- 
tion, put in by the aid of the medicine dropper, while, with a 
separate piece of cotton, the surplus solution is wiped off each 
eye, rubbing from the nose outward. 

Then with the applicator made by wrapping cotton about the 
end of a toothpick, oil is put into each nostril, all the time exer- 
cising the utmost care not to harm the tender mucous membrane. 
The ears are also carefully cleansed with a squeezed-out dip of 
boracic acid on the applicator. 

Unless there is an inflammation present in the mouth, and 
the physician in attendance has ordered mouth swabbing, do not 
touch it; for much harm is done the mucous membrane of the 
baby's mouth by the forceful manner in which much of the 
swabbing is done. The face and head are then washed with 
warm water; very little soap is needed and, when used, must 
be most thoroughly rinsed off. 

THE SECOND WEEK 

And now during the second week, we proceed to sponge the 
baby's body; the hands are washed with soap and rinsed, and, 



192 THE MOTHER AND HER CHILD 

only those who have performed this feat know just how tightly 
they hold shut their little fists. These hands must be relaxed, and 
all the lint, dirt, and perspiration be thoroughly washed away. 
The arms, shoulders, chest, and back are then sponged. All the 
time the nurse or caretaker is standing while carrying out this 
most pleasant task. At any time she may quickly cover the 
babe and stop for this or that with no inconvenience to herself 
or the child. 

After the thorough drying of baby's upper body, a bit of 
talcum is put under the arms, in the folds of neck, etc., and the 
shirt is slipped on. Next the band, diaper, and stockings are 
removed and after first oiling the groin and the folds of the 
thighs and the buttocks, the same sponging, drying, and powder- 
ing is done here as on the upper body. 

The band is now applied, and sewed on. The diaper, stock- 
ings, booties, and — if a winter baby — the skirt and outing 
flannel gown (for babies should wear only night dresses for the 
first two or three weeks) are now slipped over the feet and 
drawn upward, and baby is ready for nursing or for his nap. 

TEMPERATURE OF BATHS 

First few weeks, ioo F. ; early infancy, 98 F. ; after six months, 
97 F., cooling down to 90 F. 

A wooden bath thermometer may be purchased for twenty- 
five cents and it should be in every home where babies are 
bathed. In the absence of a thermometer do not depend upon 
the hand to determine temperature. Thrust the bared elbow 
into the water and if it is just comfortable — neither hot or 
cool — it is probably about the correct temperature for baby. 
Do not shock the baby by dashes of cold water, for, while it 
may amuse an onlooker, it unnecessarily frightens your child, 
and, subconsciously, he learns to dread his bath. 

THE BATHING PLACE 

If the bathroom is warm — temperature 75 F. — that is the 
most logical place for the bath, provided baby has his own tub. 
Place a couple of strong slats several inches wide across the 
big tub, six inches apart, and on this place the baby's tub. Of 



BABY'S BATH AND TOILET 193 

course, care must be exercised to prevent slipping by means of 
properly fitted cleats on the under surface of the slats. The 
mother should always stand to bathe her baby and the small 
tub should be placed at such a height that she neither has to 
stoop nor bend. Thus the bathing of the baby becomes a 
pleasure instead of a "job" or an "irksome task." 

If the bathroom is not warm then the kitchen table or a small 
table pulled up near the stove is a place par excellence for the 
dip. 

Many boils seen on young baby's tender skin have been traced 
to the careless use of the family tub to bathe the baby in. Not 
until the child is two or three years of age, when his skin has 
become more toughened, should he be allowed to use the 
family tub. 

FREQUENCY OF BATHS 

To begin with, we never bathe either a baby or an adult 
immediately after a full meal. From one hour to one and one 
half hours should intervene. 

The frequency of baths depends somewhat upon the season 
of the year, the vitality of the child, and the warmth of the 
home. 

We have seen many infants who were bathed too often. The 
vitality expended upon the necessary reaction following a tub 
bath was too much for the little fellow; the daily bath was 
stopped and a semi-weekly bath substituted, much to the gain 
of the child. Of course in this instance the hands, face, and 
buttocks received a daily sponging. 

The oil bath may be administered daily. In robust children 
the tub bath may be a daily affair; while in pale, anemic little 
folks, the tub bath is perhaps better given twice a week. In 
hot summer days a sponge bath may be given many times a 
day. 

BEST HOUR FOR BATHING 

Again this depends upon several factors; the warmth of 
the house or apartment, the vitality of the child, and the kind 
of bath to be administered. 



194 THE MOTHER AND HER CHILD 

An oil bath may be given any time — often it may be admin- 
istered entirely under the bed clothes, only care must be taken 
to keep oil from the blankets. 

Many of our mothers prefer to give the tub bath at five 
o'clock in the afternoon, when the house is thoroughly warm, 
and the child is thereby prepared for the long night's sleep. 
Before dressing in the morning an oil bath or rub may be 
given in such cases. 

If the forenoon is selected as the time for bathing the child, 
then an hour just before the mid forenoon meal is the best. 
In either event, be regular about it — do it at the same time 
every day. Let the caretaker attend to her many duties, and, 
as far as possible, mothers, bathe your baby yourself. The 
folds of the skin, the creases in the neck, the clenched fists, 
must all receive particular care, and no one in all the world will 
ever care as you — the mother — cares. 

SOAP AND WATER 

Select a soap free from irritants and excess of alkalis. There 
are few kinds that equal the old-fashioned, white castile soap 
our grandmothers used. 

Very hard water which makes the skin rough and sore may 
be improved by boiling, but if possible substitute rain water for 
it. A flannel bag tied over the faucet and changed each day 
will help to clarify muddy water, provided the stream flows 
gently through it. 

ROUTINE OF THE TUB BATH 

Just as we directed the nurse or caretaker to stand while the 
oil rub or sponge bath was given, so we admonish the mother 
to stand while the tub bath is given. First, get everything in 
readiness for the bath as directed for the oil bath, and then 
the baby's tub setting on the securely cleated slats placed across 
the top of the family tub may be filled with water by means of 
a hose attached to the faucet. The temperature should be 
ioo F. when baby is dipped in to be rinsed. 

The head and face toilet are identical with that described 
before, and with the baby undressed and wrapped in a warm 




Fig. 13. Supporting the Baby for the Bath 



BABY'S BATH AND TOILET 195 

towel placed inside the warm blanket on the pillow or comfort 
as before mentioned, we proceed with a good lather of castile 
soap and water to lather the baby's body all over — under the 
arms, the neck, chest, groins, thighs, buttocks, legs, feet, and 
between the toes, while the genitals also receive their share of 
attention. The foreskin of the boy baby is gently pushed back 
and cleansed thoroughly; while the vulva of the little girl baby, 
having first been swabbed with boracic acid, is now gently 
lathered and cleansed. Now grasp the ankles and legs with the 
right hand and support the upper back and neck and shoulders 
with the left and gently lower the baby into the water in a semi- 
reclining position (See Fig. 13). The water should cover the 
shoulders. Keep a good firm supporting left hand under the 
head, neck, and shoulders, and with the right, rinse all soap from 
the body. 

After this is thoroughly done, lift the baby out onto a fresh 
warm towel inside the warm blanket on the pillow, and remain 
standing, while you gently pat (never rub) the baby dry. All 
the little folds, creases, and places between fingers and toes, 
are carefully patted dry, and where any two skin surfaces rub 
together put on a bit of talcum. 

The dressing takes place in the manner already described — 
first the shirt, then the band (sewed on), the diaper, stockings, 
skirt, and gown. 

Please note that the soap bath is contra-indicated (should not 
be given) in case of eczema. 

baby's daily rub 

This soap bath should be administered for cleanliness only, 
and should be given twice a week. If a tub bath is to be given 
on other days, after the routine head and face toilet, the baby 
is simply dipped into the water and the soft skin gently rubbed. 

If the sponge or tub bath is given in the afternoon just 
before the long sleep at night, then the oil rub should take 
place before the mid- forenoon meal; and likewise, if the sponge 
or tub bath is given during the mid forenoon, then the oil rub 
or dry hand rub is given before the going-to-bed time. The 
rub should be a daily procedure for the first two years. Nothing 



196 THE MOTHER AND HER CHILD 

rougher than the soft palm of the hand should be rubbed on 
baby's soft skin. 

USE AND ABUSE OF TALCUM 

Babies have come to my clinic with cakes of talcum under 
their arms, and particularly between their thighs and in the 
crease of the buttocks. Here the well-meaning but thoughtless 
mother had reasoned, "a little is good; more is better" which 
is not always the case. 

Talcum is not used to replace careful drying, and it should 
never be found in quantities on the baby's skin any more than 
you would expect to find quantities of face powder caked in the 
creases of the neck or behind the ears of an adult. The skin 
is first cleaned, then patted entirely dry, and, as a finishing touch, 
a bit of talcum is put on by means of a puff. 

TONIC AND MEDICATED BATHS 

Tonic baths are usually given to older children when they 
are able to enter into the sport and frolic of a cool bath. Baths 
are called tonic because they call forth from the body a reac- 
tion — a sort of circulatory rebound. This rebound or reaction 
brings the blood to the skin, increases the circulation, and tones 
up the nerves. The room should be properly warmed and, if 
necessary, some form of exercise be continued after the bath 
to prevent the chill that sometimes follows a poorly administered 
bath. 

In the case of the anemic child, after six months of age, 
the mother's hand dipped in cold water may briskly rub the chest 
and back until it glows or becomes red. The child should enjoy 
this bath. Never frighten a child by throwing cold water on 
it or by giving it a too sudden cold plunge; great harm may be 
permanently done by these efforts to " toughen the baby." 

The simple medicated baths may be administered according 
to the following directions: 

Salt. Use half a teacup of common salt or sea salt to each 
gallon of water. The salt should first be dissolved in a cup 
of warm water to prevent the sharp particles from pricking 
the skin. The doctor sometimes orders a salt bath. 



BABY'S BATH AND TOILET 197 

Starch. Add a cup of ordinary, cooked laundry starch for 
every gallon of water in the bath. 

Soda. A soda bath requires two tablespoons of ordinary bak- 
ing soda to a gallon of water, dissolving it in a little water 
before adding it to the bath. 

Bran. Make a cotton bag of cheesecloth or other thin mate- 
rial, six inches square. Fill loosely with bran. Soak the bag 
in the bath water, squeezing it frequently until the water be- 
comes milky. 

Starch, soda, and bran baths are often used in place of the 
ordinary soap and water bath when the skin is inflamed, as in 
cases of chafing or prickly heat. 

FEAR OF BATHS 

Force and harshness are not likely to cause baby to overcome 
very much of the fear of a tub bath. Patience, perseverance, 
and purposeful diversion of mind will bring sure results. 

In the case of a very young baby, have a helper stretch a 
towel across the filled baby tub, lay the baby in it, with its 
head well supported, and then gently lower the towel into the 
water, keeping the head out. (Most anyone would fear an 
all-over ducking, if he had ever been completely ducked into 
water by a careless or mischievous friend). 

In the case of older children, celluloid ducks, fish, or boats 
may float about on the water, and the entire bath be forgotten 
by the little fellow's enjoyment of " his boats." 

OUT OF DOOR BATHING 

Although a baby under two years should never be given a sea 
bath, a word of caution about sea bathing for young children may 
not be amiss. The cruelty with which well-meaning parents treat 
young, tender children by forcibly dragging them into the surf, a 
practice which may be seen at any seaside resort in the summer, 
can have no justification. The fright and shock that a sensitive 
child is thus subjected to is more than sufficient to undo any 
conceivable good resulting from the plunge. On the other hand, a 
child who is allowed to play on the warm sand and becomes 
accustomed to the water slowly and naturally will soon learn to 
take delight in the buffeting of the smaller waves, but he should 



198 THE MOTHER AND HER CHILD 

not be permitted to remain more than a minute or two in the water, 
and should be thoroughly dried, dressed immediately, and not left 
to run about the beach in wet clothing. 

MILK CRUST 

Any roughness on the scalp must receive immediate atten- 
tion. This roughness, or milk crust, is entirely avoidable; it 
is the result of accumulated oil and dirt. When it has formed 
a complete crust or cake, it may quickly become eczematous 
and require a physician's advice; however, in the beginning, 
at the first sight of brown patches or roughness, oil the scalp 
thoroughly at night with vaseline or cold cream, which should 
be gently rubbed off in the morning. 

This vaseline or cold cream should be applied repeatedly, 
several nights in succession, followed by the morning's gentle 
rubbing and daily washing of the head. Often the washing 
with water must be entirely avoided; only sweet oil or 
vaseline being used in those cases where the crusting seems to 
be persistent. 

THE EYES, EARS, AND NOSE 

At birth the eyes are particularly cared for. First, the mucus 
is gently swabbed off the closed lids from the nose side out- 
ward, and then follows the application of one drop of twenty 
per cent argyrol or two per cent silver nitrate, either of which 
thoroughly disinfects the eye and prevents the growth or 
development of any bacteria that may have gotten into the 
child's eye during the descent of the head through the birth 
canal. The neglect of this procedure may sometimes result 
in lifelong blindness. 

Under no circumstances should " a mere cold in the eyes " 
be neglected; it may result in blindness. Call your physician 
at once, and if he is not at hand, wash out the eye thoroughly 
every hour with warmed ten per cent boracic acid solution, by 
means of a medicine dropper, using a separate piece of cotton 
for each eye, for if the slightest bit of discharge be carried 
from one eye to the other an inflammation will quickly appear. 

From birth, especially during the first week, baby's eyes are 



BABY'S BATH AND TOILET 199 

very sensitive to light; hence they must be carefully protected. 
Babies should be so placed during their outings, sleep, or naps, 
that they do not directly gaze at either the sunlight or sky. 
The lining of the hood of the carriage should be green, instead 
of white, as much eye strain is thus prevented. 

The daily care of the normal, well eye has been already de- 
scribed, and while it need not be reiterated, we may say, in 
passing, that if the eyelid be at all inclined to be sticky or 
adherent, never use force, but instead, gently swab with boracic 
acid. As a preventive of this condition, a little vaseline from 
the tube may be rubbed on the edges of the lids at night. 

In the toilet of the ears, never attempt to introduce anything 
beyond the external ear, which may be carefully cleansed with a 
soft cloth. It is often found necessary to apply oil to the creases 
behind the ears before the daily bath. There should be no 
irritation, redness, or roughness present, all such conditions 
being readily prevented by the use of oil or vaseline before the 
bath. 

With the sharp point removed, make a cotton applicator out 
of a toothpick, and gently (with no force, whatever) intro- 
duce vaseline or oil into the nose. This should be a part of 
baby's daily toilet. Any stoppage of mucus or snuffiness in the 
nose should be reported at once to baby's physician. Young 
babies often have adenoids. 

CARE OF THE MOUTH 

Leave the well mouth alone until the teeth appear, and then 
keep the teeth very clean (allowing no particles of milk to 
accumulate at their bases) with a soft bit of cotton and gentle 
rubbing. When a child attains the age of two, he should have 
his own toothbrush; previous to this time all food particles 
should be removed from between the teeth with waxed silk 
floss. All decay should be promptly attended to by a competent 
dentist. 

Thrush and ulcers are often caused, not prevented, by the 
frequent wiping out of baby's tender mouth. The treatment 
of thrush and other mouth infections will be considered in a 
later chapter, " The Common Disorders of Infancy." 



200 THE MOTHER AND HER CHILD 

THE CARE OF THE GENITAL ORGANS 

Before the bath, the baby girl's genitals are carefully swabbed 
between all the folds with boracic acid solution. The fore- 
skin of the boy baby should be pushed well back and washed 
gently with water. If the foreskin of the male child be 
long, tight, or adherent, circumcision is advised. See our chap- 
ter, " Teaching Truth." 

The genitals of both the boy and girl should be kept scrup- 
ulously clean every day, with as little handling as possible, and, 
upon the appearance of the least swelling, discharge, or even 
redness, the physician's attention should be at once called to it. 
In a later chapter, the subject of irregularities of sex habits 
will be taken up. 

CARE OF THE BUTTOCKS 

Often, because of irritating bowel movements, the buttocks 
become reddened, chafed, and sometimes raw in places. Some 
poor little babies are sometimes roughly rubbed — scoured on 
the buttocks — much like the kitchen sink, many times a day, 
and it is not surprising that they become reddened, chafed, and 
very much inflamed. 

The buttocks require a gentle swabbing and thoroughgoing 
" patting dry " after each soiling or wetting of the diaper, but 
no soap is required in this region but once a day, and even 
then it should be used sparingly. 

When the buttocks are inflamed, after a good cleansing with 
water and a thorough drying, vaseline or zinc ointment should 
be applied on a piece of sterile cotton, and this application should 
be repeated after each changing of the diaper. Wet diapers 
should be removed at once, for the acidity of the urine causes 
more chafing. A dusting powder composed of starch two parts, 
and boracic acid one part, may be dusted on after a cleansing 
with oil. 

Great care should be exercised in the thorough daily rinsing 
of the diapers as well as in the tri-weekly boil in the laundry. 
White soap only should be used in their cleansings ; no washing 
sodas or other powders should be used. 



BABY'S BATH AND TOILET 201 

OTHER SPECIAL CARE 

Under the arms and in the creases of the neck the skin some- 
times becomes irritated because of neglect. To prevent such 
chafing the following program should be carefully carried out: 

1. Not too much soap — and no strong soap. 

2. Careful rinsing of the skin area. 

3. Avoid harsh rubbing, but thoroughly dry. 

4. The use of talcum powder in all folds of the skin. 

With a fine camel's hair brush the hair should receive its 
brushing after the cleansing of the scalp. Combs are for just 
one purpose and that is to part the hair. The brush should be 
used to do all the smoothing. 

While the frequent trimming of the hair has no marked effect 
upon its growth, yet the comfort the little girls enjoy, especially 
during the warm-weather months, should not be denied them. 

And certainly the boy should become a boy when he puts on 
trousers and not be made the laughing stock of his mirthful 
companions just because his " beautiful long curls are much 
admired by the mother and his aunts." 

The finger nails should be trimmed round with the scissors, 
while all hangnails are properly cared for every day. Toe nails 
should be cut straight across and the corners never rounded off. 
Many ingrowing nails may be thus avoided. 



CHAPTER XXI 
BABY'S CLOTHING 

THE Eden story suggests that in the beginning of our racial 
experience artificial clothing was unnecessary; but after a 
time, in that selfsame garden, proper clothing became an im- 
portant problem and has remained so ever since. Everybody 
seems to agree, however, that baby's clothing in particular should 
at least be comfortable. It may give the child great discomfort 
because it may be too warm, or it may not be warm enough, or it 
may be too tight, and so, in the discussion of baby's clothing in 
this chapter, we are going to keep in mind these two things — 
comfort and heat. 

GENERAL SUGGESTIONS 

The choice of material demands some thought and attention. 
As a rule, baby's clothing materials should be light in weight, 
good moisture absorbers, and at the same time able to retain the 
body heat. Most layettes have the common fault of being pre- 
maturely outgrown; and so it is well to allow for ample growth 
in making baby's first clothes. Since the principal object of 
clothing is to insure a uniform body temperature, it is important 
that the mother be constantly on her guard to keep the baby 
cool enough in the summer and warm enough in the winter. 

The mothers of various races and nations have their own ideas 
concerning the clothing of their babies. One mother will wrap 
her baby in cotton, which is held in place by means of a roller 
bandage, and as you visit this home during the first week of 
baby's life, you will be handed a little mummy-shaped creature 
— straight as a little poker — all wrapped up in cotton and a 
roller bandage. The surprising feature is that the baby does not 
seem to complain. 

202 



BABY'S CLOTHING 203 

In another district of the city we find the baby dressed in 
starched clothes, ribbon sashes, bright ribbon bows on its arms 
and around its neck. At first glance you wonder if the little 
child is not many years older and is about to make a visit to a 
county fair, but on inquiry we find that he has only been pre- 
pared for the event of circumcision on the eighth day. 

And if you go into the forest of primeval days you will find 
another mother bandaging her baby to a board, head and all, and 
he seems to live and thrive in his little woven nest strapped on 
the back of his Indian mother. 

Other babies in the warmer portions of the earth have almost 
less than nothing on, and are left to be swung by the breezes 
in little baskets tied to the boughs of trees; being taken up only 
when it is time to feed. 

baby's layette 

In preparing an outfit for the newcomer it is wise to provide 
for the necessities only, because of the fact that since the baby 
grows very fast the layette will soon have to be discarded; it 
is always possible to get more clothing after the baby is here 
and started on his little career. We offer the following list of 
essentials for the new born baby: 

Slips 8 to 10 

Skirts (flannel) 3 

Shirts , 3 

Light-weight wool wrappers 2 

Abdominal bands 3 to 5 

Diapers (first size) 2 doz. 

Diapers (third size) 2 doz. 

Stockings, pairs 3 

Booties, pairs 3 

Nightgowns 7 

Handling blankets 2 

Silkaline puffs 2 

Baby blankets, pair 1 

Hair or cotton mattress 1 

Basinet 1 



204 THE MOTHER AND HER CHILD 

BANDS AND SHIRTS 

The binder should be made of an unhemmed strip of flannel 
six inches wide and twenty inches long, so that it goes around 
the abdomen once with a small overlap. This binder should be 
sewed on instead of being pinned, and serves the purpose of 
holding the dressings of the cord in place. It is usually worn 
from four to six weeks, when it is replaced by a silk and wool 
barrel-shaped band with shoulder straps and tabs at the bottom, 
both front and back, to which may be pinned the diaper. This 
band is worn through the first three or four years to protect 
the abdomen from drafts and chilling, thus guarding against 
those intestinal disturbances which are caused by sudden weather 
changes. 

There is great danger of having the bellyband too tight, and, 
in the early weeks, it is often the cause of great discomfort — 
often interfering with the normal expansion of the stomach at 
meal time. 

No matter what the season, the new-born baby should be 
clothed in a light-weight silk and wool shirt, preferably the sec- 
ond size. After the first month, if the weather is exceedingly 
warm, this woolen shirt may be displaced by a thin silk or lisle 
shirt. In buying the second-size shirts always secure the 
stretchers at the same time, for in the laundering they soon 
shrink so that they are very uncomfortable for the young babe. 

DIAPERS 

There are a number of materials on the market from which 
comfortable diapers may be made for the baby. The cotton 
stockinet (ready-made shaped diaper) is excellent, fitting 
smoothly at the waist, while it is large and baggy at the seat, 
thus permitting not only a comfortable feeling but the free use 
of the hips, without the bulkiness of the ordinary diaper. 

The large square of cheesecloth is easily laundered, and if an 
inside pad is used makes a very acceptable diaper. 

The stork diapers are made of materials resembling turkish 
toweling and are used to some extent. This diaper should not 
be confused with the stork rubber diaper which will be spoken 
of later. 



BABY'S CLOTHING 205 

Birdseye cotton is popular and extensively used. It absorbs 
quickly, and is much lighter in weight than linen. The first- and 
third-size widths should be purchased as a part of the layette, 
and the number of diapers needed depends upon the opportuni- 
ties to wash them out, for diapers are never used but once with- 
out washing; they should always be quickly rinsed and dried 
in the sunshine if possible. So if there are good laundry 
privileges, and daily washing is possible, the mother can get 
along with fewer diapers, but no less than four dozen should 
be provided. 

The diaper pad will be found convenient and serviceable in 
the early days when the skin of the child is so very tender. This 
pad should be pieces of clean old linen or small pads of ab- 
sorbent cotton. 

CHANGING THE DIAPER 

During the mother's waking hours, the diaper should be 
changed as soon as it is soiled or wet. If the child cries 
during the night it should be changed immediately, but 
the mother should not feel called upon to lay awake nights 
merely to change the baby's napkin when it is soiled. If she 
places a pad underneath the baby, which will absorb the urine 
quickly, he often does not awaken or become chilled. The pad 
should be sufficiently thick to ensure that the nightgown does 
not get wet. 

RUBBER DIAPERS 

Rubber sheeting diapers of any description should never be 
used. Avoid all patent diapers with a covering or an inner lin- 
ing of rubber, for, like the rubber diaper, they not only irritate 
the child but also retain moisture and heat, which produce 
such irritation and itching that the subsequent " habit-scralch- 
ing " often lays the foundation for future bad practices. It is 
far better for the mother to carry about with her, whenever it 
is necessary to take the baby away from home, a rubber pad 
which she puts on her lap underneath the little fellow, thus 
affording ample protection to herself without in the least harm- 
ing the baby. 



206 THE MOTHER AND HER CHILD 

STOCKINGS AND BOOTIES 

During the winter months merino stockings are required, 
while during the summer months a thin wool or silk stocking is 
sufficient; on the extremely hot days thin cotton hose may be 
worn. During infancy, the stockings should be fastened to the 
diaper with safety pins, while on the second-year child, hose 
supporters attached to the waist are found very convenient. 

A friend told me the other day of a mother who told her 
the following story : " Do you know, I don't have any trouble 
any more about my baby keeping up his socks for I have fixed 
it so they won't come off any more. Every time I looked at his 
feet he had kicked off his socks and they were no good to him 
at all, so I took little chunks of brown laundry soap, moistened 
them and rubbed his legs, as well as the inside of his socks and 
I never, never have any more trouble with them coming off." 

It does not seem possible in this enlightened age that a mother 
could be so ignorant as to keep the socks up with brown soap, 
but the friend assured me it was a true story, and while it may 
shock some of my readers as it did me, I must add, in passing 
to another subject, that the use of round garters on little babies 
and young children is just about as shocking. 

During the fall, winter, and spring, booties are worn on top 
of the stockings. These booties should be crocheted or knitted 
out of the heavy Germantown yarn, and there should be enough 
of them so that the child may have a clean pair on every day. 

SKIRTS AND PETTICOATS 

The flannel petticoat is made with yokes instead of bands, 
and during the fall, winter, and spring these yokes are made of 
flannel like the skirt and should have long sleeves of the same 
material. The yokes should be made large enough so that they 
may be used during the entire first year (the plait in the front 
can easily be taken out when the baby is six months old so that 
it may be used much longer than if the yoke is made without a 
plait). For the hot summer months, the yokes should be a 
thin cotton material without sleeves; and, if the baby is housed 
in an over-heated apartment, this fact should be borne in mind 
and the winter skirt should be made accordingly. We have 



BABY'S CLOTHING 207 

found, however, that the baby who is amply protected and uni- 
formly dressed, does not require the outer bundlings that the 
poorly dressed child requires. Part wool and cotton materials 
are very comfortable in the overheated city apartments. White 
skirts are not necessary for small babies. They only add extra 
weight and it is always foolish to put anything on a small baby 
simply for looks. 

NIGHTGOWNS, WRAPPERS, AND SLIPS 

The nightgowns should be made of soft cotton flannel or 
stockinet. The latter is really the better, and can be pur- 
chased in sizes up to two years; it is absorbent, easily laun- 
dered, and may be conveniently drawn up at the bottom by means 
of a drawstring. 

At least seven nightgowns are needed. A fresh nightgown 
should be used each day and each night during the first four 
or five weeks of baby's life; while as he gets older (two or three 
years), the night drawers with feet in them are used to ad- 
vantage. 

The wrappers are usually made of challis, nun's veiling, cash- 
mere, or other light woolen materials which can be readily 
washed. They are very serviceable to wear over the baby's 
thin slips and on cool nights they may be used over the night- 
dress. They should be simply made, containing no heavy seams, 
and at the neck there should be the simplest kind of a soft band 
that will in no way produce friction or in any other way irri- 
tate the baby's skin. 

Slips are usually made of some very soft material such as 
nainsook, batiste, pearline, or sheer lawn cloth. Twenty-seven 
inches is the length that will be found both comfortable and 
convenient. All laces, ruffles, and heavy bands which will 
scratch or irritate should be avoided as eczema is often caused 
by such mistakes. 

SLEEPING BAG 

The sleeping bag is of inestimable value, affording extra and 
secure covering for the child, and peace of mind for the 
mother. In the early weeks it should be made of light flan- 



208 THE MOTHER AND HER CHILD 

nel, but as the child gets older the sleeping blanket is made 
according to illustration (See Fig. 5) by merely folding a 
blanket in such a manner that the child cannot possibly uncover 
himself. The mother can sleep undisturbed, knowing that the 
baby is always safely protected by at least one warm blanket 
cover. 

COMMON FAULTS WITH MOST LAYETTES 

As a usual thing the first clothes are made too small. The 
sleeves are too short as well as too small around. There is 
nothing more uncomfortable than a tight sleeve. Everyone of 
our readers knows that, and we recall one poor little fellow who 
kept up a fretful cry until we took the scissors and cut the 
tightly stretched sleeve up to and including the arm hole. He 
then relaxed and went to sleep. Sleeves should be made two 
inches longer than they are needed at first, and it is a very sim- 
ple matter to pin them up or turn them back at the wrist. They 
should be loose and roomy. 

The yokes of the dresses usually are too tight before the slips 
are discarded. Heavy seams and raw seams irritate and often 
make ugly impressions on the baby's skin. 

Usually the first layette is profusely embroidered, and, while 
it is beautiful to look at, the mother feels when she sees it out- 
grown so quickly that a lot of vital energy was wasted on gar- 
ments that mattered so little as long as baby was comfortable. 
Baby is dear and sweet enough without the fuss and furbelows 
of such elaborate garments. 

Heavy materials are sometimes used where lighter ones would 
serve better. 

ERRORS IN CLOTHING 

A soiled garment should never be put back on the baby. Dirt 
draws flies, and flies are breeders of disease. Sour-smelling 
garments should be changed at once. They are likely to make 
the baby sick and interfere with his appetite if left on indef- 
initely. The care of the diaper has already been mentioned. 

The main symptom of too much clothing is sweating, and 
when the baby sweats something must come off. If he has 



BABY'S CLOTHING 209 

perspired so much that his clothes are moist, the clothing should 
be changed and the skin well dried with talcum powder. The 
feet and hands should be kept warm, but the little head should 
always be kept cool. When the baby is crying and getting his 
daily exercise, remove some of the covering, loosen his diaper, 
and let him kick and wave his arms in perfect freedom. 

When the baby's feet and hands are cool he is not warm 
enough. Cotton underskirts cannot be used in the dead of win- 
ter on little babies. They do not hold the body heat as woolen 
garments do. The baby's feet should always be warm and this 
is particularly necessary in poorly nourished children. The 
outer wrapper of woolen material should be added to such 
baby's clothing. It is a safe rule to follow that if baby's hands 
are warm and he is not sweating, he is " just about right." 

SHORT CLOTHES 

At the age from four to six months, baby's clothes are short- 
ened. This should not take place at the beginning of winter 
if it can be avoided. If the first layette has consisted of only 
the necessary garments, they are nearly worn out by the time 
the short clothes are due; of those that do remain, the sleeves 
should be lengthened, the arm holes enlarged, and all the little 
waists let out. Creeping garments and bibs are now added to 
baby's outfit, as well as leggings and other necessities for out- 
door wear. Remember that all garments must be loose — then 
baby is happy. 

About the same number of garments are found necessary 
for the short clothes as were required at first; except that a 
large number of creeping rompers should be added. These 
creeping rompers should not be made of dark materials that do 
not show the soil. We desire the dirt to be seen that we may 
keep the baby clean, and if the creeping romper is made of a 
firm, white material it may be boiled in the laundry, thus afford- 
ing ample and thorough cleansing. 

We attributed a sick spell of one baby to the dark-blue calico 
creeping romper which he wore day in and day out because it 
" did not show " the soil. White ones are much to be preferred, 
not only for looks but chiefly for sanitary reasons. 



210 THE MOTHER AND HER CHILD 

CAPS AND WRAPS 

The cap should be made of a material that will protect irom 
drafts and cold air, but not of such heavy materials as will cause 
too much sweating. There are a number of outside wraps that 
can be purchased ready-made and which are comfortable, con- 
venient, and warm. They should be long enough not only to 
cover the baby's feet well, but to pin up over the feet, thus 
giving good protection from winds and drafts. 

During the summer months nainsook caps or other thin mate- 
rials are to be preferred to the heavy crocheted caps that are 
sometimes worn by babies. No starch should be used in the 
caps or strings, and there should be no ruffles to scratch the 
delicate skin of the baby. In all these outer garments, as well 
as the under garments, the irritation of the skin must be con- 
stantly borne in mind, as eczema is often produced in this 
manner. 

THE FIRST SHOES 

The first shoe that is usually worn during the creeping days 
is a soft kid shoe without hard soles. It is important that this 
soft shoe be worn to protect the child's foot from chilling 
drafts while creeping about. 

As the baby nears one year of age the hard-sole shoe is 
secured which must be wide, plenty long and comfortable in 
every respect, and without heels. Rubbers and overshoes may 
be worn on damp and cold days. Moccasins and slippers do not 
give sufficient support to the ankles, so, when the baby begins to 
walk, the shoes should be high and of sufficient support to the 
tender ankles. 

PLAY SUITS 

As the baby grows up into the child, the tiny clothes are laid 
aside and the boy is given substantial garments that in no way 
remind him of girls' clothing. A child's feelings should be re- 
spected in this manner, and while it often adds joy to the 
mother's heart to see her boy " a baby still," remember that he 
is not only chagrined but is nervously upset by these " sissy 
clothes." 



BABY'S CLOTHING 211 

A child three or four years of age should still wear the 
woolen binder supported from the shoulders, over which is the 
union suit, stockings, and the buttoned waist from which hang 
the hose supporters. The most comfortable and easily laun- 
dered garment we know of for the small lad is the " romper," 
which should be made of washable materials that may be readily 
boiled. For cool days a Buster Brown coat of the same mate- 
rial, with patent-leather belt, may be slipped on over this wash- 
able romper — which completes the boyish outfit. 

We recall the pleasant days with our own little fellow when 
he was between the ages of two and one-half and five years. 
We were often compelled to be away from home — on the train, 
in the hotel — and when traveling we used a black, smooth silk 
material which was made up into rompers with low neck and 
short sleeves. There were three such rompers, and two Buster 
Brown coats with wide, black, patent-leather belts which com- 
pleted the traveling outfit. During the warm days on the train 
the coat was folded carefully and laid aside. In the early 
morning and in the cool of the evening the coat was put on, 
and he always looked neat and clean. At night, before un- 
dressing him, the entire front of the romper was cleansed with 
a soapy washcloth, rinsed, and rubbed dry with a towel, and, 
after carefully spreading to avoid wrinkles, it was hung over 
the foot of the bed. The coats were sponged or pressed once 
or twice a week, and this simple outfit served its purpose so well 
that it was repeated three different summers. 

The little girl as she leaves her babyhood days should be put 
into garments that do not necessitate the constant admonition, 
" Keep your dress down, dear." We like to see knickerbockers, 
the exact color of the dress, made for every outfit, in which the 
little girl may kick, lie down, jump, dance, climb — do any- 
thing she pleases — unmindful of the fact that her " dress is 
not down." The same undergarments are used for the little 
girl as were mentioned for the little boy. 

WINTER GARMENTS 

Always bear in mind the over-heating of the child with heavy 
garments indoors, and the danger of skin chilling and drafts on 



212 THE MOTHER AND HER CHILD 

going out to play in this over-heated condition. Let the chil- 
dren dress comfortably cool in the house, and as they go out 
to play add rubber boots or leggings and rubbers, sweaters, caps 
with ear laps or the stockinet cap. Allow them the utmost 
freedom in clothes, and always encourage romping in the cool 
frosty air. 

CLOTHING RULES 

Do not overload the baby with clothing. 
Dress according to the temperature of the day and not the 
season of the year. 

Avoid starched garments. 

Avoid tight bellybands or old-fashioned pinning blankets. 

Change all clothes night and morning. 

Use woolen shirts and bands. 

See that hands and feet are always warm. 

Protect the abdomen night and day with the band. 

Use the sleeping bag on cold nights. 

Baby should sleep in loose stockings at night. 

Avoid chilling the child. 

Use hot water bags if necessary. 



CHAPTER XXII 
FRESH AIR, OUTINGS, AND SLEEP 

FRESH air is just as important and necessary for the baby- 
as for the adult. Neither baby, youth, nor adult can re- 
ceive the full benefit of his food — in fact it can not be burned 
up without the oxygen — without an abundance of fresh air. 
During the early weeks of life, the air baby breathes must be 
warm; nevertheless, it must be warmed fresh air, for baby 
requires fresh air just as much as he needs pure food. 

INDOOR AIRING 

The delicate child often requires more fresh air than does 
the normal baby. Both appetite and sleep are improved by fresh 
air. The digestion is better, the cheeks become pink, and all 
the signs of health are seen in the child who is privileged to 
breathe fresh air. 

During the early days, say after the third week, baby should 
be well wrapped up with blanket and hood, tucked snugly in 
his basinet or carriage, while the windows are opened wide and 
the little fellow is permitted to enjoy a good airing. Even in the 
winter months the windows may be raised in this way for a few 
minutes each day. These " airings " may be for ten minutes 
at first, and, as the child grows older, they may be gradually 
increased to four or five hours daily. The carriage or basket 
should stand near the window, but not in a direct draft. 

OUTDOOR LIFE 

In summer, a baby one week old may be taken out of doors 
for a few minutes each day; in the spring and fall, when baby 
is one month old, it may go out for an airing; while, during 
the winter months, the airing had better be taken indoors until 

213 



214 THE MOTHER AND HER CHILD 

lie is about two months old, and even at that age he should go 
out only on pleasant days and should always be well protected 
from the wind. 

A young baby may enjoy the fresh air in his carriage or crib 
on the porch, on the roof under suitable awnings, in the yard, 
under the trees, and even on the fire escape. In fact, at proper 
age and in season, he may spend most of his time out of doors 
in the fresh air, if he has proper protection from the sun, wind, 
and insects. 

BEST HOURS FOR AIRING 

During the balmy days of summer and early autumn, baby 
may spend most of the time outdoors between seven in the morn- 
ing and sunset. During the cooler days of winter and the cool 
and windy days of spring, the best hours for the airing are to be 
found between eleven in the morning and three in the after- 
noon. 

At six weeks, perhaps an hour a day in the fresh air is suffi- 
cient; while at six months, four to six hours a day are a neces- 
sity, and from then on — the more the better. 

Now we realize that the mother of the farm household does 
not always have as much time to take the baby out for his 
airings as many of our city mothers; but we suggest to this busy 
mother that the baby be rolled out on the porch or in the yard, 
within her sight and hearing, and allowed to enjoy the fresh 
air while the mother continues her work. 

It is virtually a crime to try to keep baby in the kitchen, hour 
after hour, while the busy mother is engaged at her tasks. A 
hammock, a crib on casters, or a carriage, is just the coziest 
place in the world for baby — out on the porch. 

THE COUNTRY BABY 

The average city baby really gets more fresh air than ninety 
per cent of the country babies. Our city apartments are usually 
steam heated, and our windows are open in the winter nearly as 
much as in the summer. The country home is often only par- 
tially heated by two or three stoves. The windows are closed 
in summer to keep out the dust, heat, and flies, in the winter to 



FRESH AIR, OUTINGS, AND SLEEP 215 

shut out the cold, and so the baby who lives in such a home has 
little chance to get fresh air. 

The city mother is constantly talked to about the benefits of 
fresh air. The daily paper brings its health column to her, 
her pastor talks of it on Sunday, and — best of all — the older 
children come home from school and reiterate the doctrine of 
fresh air that is constantly being preached to them at school. 

Screen the windows, rural mother, and oil the roads in front 
of your residence, and then keep your windows open. Remem- 
ber that baby's health is of more value than the meadow lot 
or even a fortune later on in life. Plan for a new heating plant, 
if necessary, so that the home can be both warmed and venti- 
lated during the winter. 

WHEN NOT TO TAKE BABY OUT 

If a sheltered corner of the porch is within the reach of the 
mother, we can hardly think of a time when the baby cannot 
be taken out. It may rain, the wind may blow, it may snow or 
even hail, but baby lies in his snug little bed with a hot water 
bottle or a warmed soapstone at his feet. As long as the finger 
tips are warm, we may know he is warm all over, and a long 
nap is thus enjoyed in the cool fresh air. When the sheltered 
corner of the porch is lacking, we wisli to caution the mother 
concerning the following weather conditions : 

1. When the weather is excessively hot, take him out only 
in the early morning and late in the afternoon. 

2. In extremely cold, below zero, weather, let his airing be 
indoors. 

3. Sharp and cold winds may do much mischief to baby's 
ears, as well as blow much mischief-making dust into his nose 
and eyes. In the case of dust or sand storms, baby remains in 
the house. 

4. All little people enjoy the rain, and only when the rain- 
coat, rubbers, and umbrella are missing should they be robbed 
of the " rainy-day fun." In the case of baby's outing on rainy 
days, ample roof protection is the only factor to be considered ; 
if it is adequate, then take him out; if it is lacking, let the air- 
ing be done indoors. 



216 THE MOTHER AND HER CHILD 

WINTER OUTINGS 

The very young baby is taken out for a fifteen -minute airing 
during the noon hour when he is two months old; before this 
time he receives his airing indoors. The interval is gradually 
lengthened until most of the time between eleven and three is 
spent out of doors. The reddened cheeks, the increased appe- 
tite, all tell the story of the invigorating benefits of cool, fresh 
air. Most babies dislike heavy veils, and they may be avoided 
by a fold of the blanket arranged as a protection shield from 
the wind. 

The wind shield, procurable wherever baby carriages are 
sold, should be a part of the outdoor equipment, as it greatly 
helps in the protection of the baby. 

The wind should never blow in his face; neither should he 
lie, unprotected, asleep or awake to gaze up into the sunshine 
or the sky — or even at a white lining of the hood of his car- 
riage. The lining should be a shade of green, preferably dark 
green. And while it may be necessary during the summer to 
suspend a netting over the carriage to protect from flies, mos- 
quitoes, etc., it should never lie on his face. 

OPEN WINDOWS 

Many of our readers recall with sadness of heart a little 
hunchback child or a life-long invalid confined to a bed or wheel 
chair because some careless but well-meaning caretaker or 
mother left an open window unguarded; and — in an unlooked 
for moment — baby crawled too near, leaned out too far, and 
fell to the ground. The little fellow was picked up crippled 
for life; and so while it is very essential to baby's health to 
have open windows, admitting fresh air, they should be amply 
guarded. Screens afford protection if well fastened, and in 
their absence a slat three inches wide and one inch thick may 
be securely fastened across the opening, thus preventing all such 
tragedies with their life-long regrets. 

SLEEP 

If any of our readers have seen a new-born baby immedi- 
ately after he has been washed, dressed, and comfortably 



FRESH AIR, OUTINGS, AND SLEEP 217 

warmed, they have observed that he usually goes to sleep at 
once, and that he generally sleeps from four to six hours. 
Babies, especially new-born babies, need just four things: 
warmth, food, water, and sleep. 

And while the babies sleep they are not to be disturbed by 
the fond mother's caresses and cuddling — feeling of the tiny 
hands, smoothing out the soft cheek, or stroking his silky hair 
— for all such mothers are truly sowing for future trouble. Let 
baby absolutely alone while sleeping, and let this rule be main- 
tained even if some important guest must be disappointed. If 
such cannot wait till baby wakens, then he must be content with 
the mental picture drawn from the mother's vivid description of 
baby — his first smile, his first tooth, his first recognition of the 
light, etc. The wise mother cat never disturbs her sleeping 
kittens. 

SLEEP REQUIREMENTS 

Sleeping, eating, and growing occupy the whole time of young 
babies. Until they are two months old they need from eighteen 
to twenty hours sleep out of each twenty- four; and not less 
than sixteen hours up to the end of the first year. 

At six months, baby should sleep right through the night 
from six in the evening until six in the morning, with a ten 
o'clock feed, which should be given quietly, in a darkened 
room, the babe being immediately returned to his bed. 

At two or three years of age, twelve to fourteen hours of 
sleep is required; while at four. to five years, eleven to twelve 
hours are needed; when they attain the age of thirteen years 
they should still have ten hours of unbroken sleep each night. 

As a general rule, children should sleep alone; even in the 
case of two brothers or two sisters, separate beds are far bet- 
ter than a double bed for both hygienic and moral reasons. 

Baby should have a separate bed. The temptation to nurse 
him on the least provocation, as well as the danger of over- 
lying, are reasons enough for such an arrangement. 

PUTTING BABY TO SLEEP 

At five-thirty in the afternoon, baby should be undressed, 
rubbed or bathed, made perfectly comfortable, and fed; then, 



218 THE MOTHER AND HER CHILD 

my mother reader, he should be lajd down in his little bed and 
allowed to go to sleep, without any coaxing, singing, rocking, 
or even holding his hand. Babies will do this very thing and 
continue to do it if you never begin to rock, jolt, bounce, or sing 
to them; and, mind you, if you do sing to them or rock them, 
or even sit near without doing anything but " just hold their 
tiny hands," there will come a time when you greatly desire to 
do something else — you have many urgent duties awaiting 
you — and baby not being old enough to understand the cir- 
cumstances, begins to wail out his feeling of neglect and abuse. 
It is nothing short of wicked thus to spoil a child. 

We have seen so many beautiful babies go to sleep by them- 
selves without any patting, dangling, or rocking, that we en- 
courage and urge every mother to begin right, for if the little 
one never knows anything about rocking and pattings he will 
never miss them; and even if the baby is spoiled through extra 
attention which sickness often makes necessary, then at the first 
observance of the tendency on the part of the child to insist on 
the rocking, or the presence of a light in the sleeping-room, or 
the craving for a pacifier, we most strongly urge the mothers 
to stick to the heroic work of " letting him cry it out." 

The notion that the household must move about on tiptoes 
is not only unnecessary but perfectly ridiculous. From the very 
hour of his birth, let the child become accustomed to the ordi- 
nary noises of the home, and if this plan is early started he 
will prove a blessing and a ray of sunshine to the family and 
not an autocrat to whom all must bow and bend the knee. 

BEDTIME AND SLEEPING POSITION 

Bedtime is regulated somewhat by the hour of rising in the 
morning. Usually, up to two years, baby is put to bed from five 
to six p. m. Regularity is urged in maintaining the bedtime 
hour. 

The seven o'clock bedtime hour is later established and con- 
tinued until the young child attains school age, when retiring 
at the curfew hour of eight o'clock gives our boy or girl from 
ten to eleven hours of sleep, which is essential to proper growth, 
calm nerves, and an unruffled temper. 



FRESH AIR, OUTINGS, AND SLEEP 219 

The first few days finds our little fellow sleeping nine-tenths 
of his time. Let him lie on his right side, for this favors the 
complete closure of the fetal heart valve, the foramen ovale. 

Whether baby lies on his stomach, his side, or with the hands 
over his head is of little or no consequence. His position should 
be changed first from one side to the other until he is old enough 
to turn himself. 

WAKING UP AT NIGHT 

Before baby is three months old, he should receive nourish- 
ment during the night at nine and twelve, and again at six in 
the morning. After four or five months a healthy child should 
not be fed between the hours of ten p. m. and six a. m. At this 
age, many children sleep right through from six p. m. to six 
a. m. without food. 

After five months, if a healthy baby awakens between ten 
p. m. and six a. m. warm water may be given from a bottle ; he 
soon forgets about this and the night's sleep becomes unbroken. 
There are many other reasons than the need of food that cause 
the wakefulness of the child; and since the baby should, after 
a few months, sleep undisturbed and peacefully, if he is wake- 
ful and restless — crying out in a peevish whine — and then 
quiets down for a few moments only to cry out again, you may 
suspect one of a half-dozen different things. Let us, therefore, 
summarize the things which may disturb baby's sleep : 

1. Lack of Fresh Air. Babies cannot sleep peacefully in a 
hot, stuffy room, or in a room filled with the fumes of an oil 
lamp turned low. A crying fretful baby often quiets down as 
if by magic, providing he is not hungry and the diaper is dry, 
when taken into a cool room with fresh air. After the first two 
months the temperature of the sleeping room should be fairly 
cool and fresh. 

2. Clothes and Bedding. The night clothes may be irritating 
and causing perspiration, while the bedding may be wrapped too 
snugly about the child. If baby's neck is warm and moist, you 
may know that he is too warm. If the diaper is wet it should 
be changed at once. One of the worst habits a baby can pos- 
sibly get into is to become so accustomed to a wet diaper that 



220 THE MOTHER AND HER CHILD 

it does not annoy him. In cold weather he is changed under 
the bed clothing without exposure or chilling. It may be the 
bedding is cold and, if so, it should be warmed up by the 
use of the photophore previously described, or by means of the 
flannel-covered hot water bottle. 

3. The Food. Too little, too much, or the wrong kind of food, 
will disturb baby's sleep. Indigestion is very easily produced in 
babies who are improperly fed. For instance, the mother's milk 
may be lacking in nourishment and baby may really be hungry ; 
or, as in the case of a bottle-fed baby, it is usually due to over 
feeding. Many mothers we have known who sleep with their 
babies or who sleep very near them, nurse them every time they 
wake up or murmur, and this soon becomes one of the biggest 
causes of disturbed sleep. 

4. Spoiling. A lighted nursery or bedroom, rocking to sleep, 
jolting the carriage over a door sill or up and down, the habit of 
picking baby up the moment he cries, late rompings — any and 
all of these may disturb sleep, as well as unsettle the tender 
nervous system of the child, thus laying the foundation for 
future nervousness, neurasthenia, and possibly hysteria. This 
is particularly true in the case of the children who have nervous 
parents. 

5. Reflex Causes. Wakefulness is sometimes due to reflex 
nervous causes such as the need for circumcision, or the pres- 
ence of adenoids, enlarged tonsils or worms. Does baby have to 
breathe through his mouth? Then you may suspect adenoids 
or other conditions which should be removed. 

6. Chronic Disorders. The presence of scurvy or syphilis 
causes the child to cry out sharply as if in acute pain, while 
in older children tuberculosis of the spine or hip is attended by 
a sharp, painful crying out during sleep. Malnutrition or 
anemia are also conditions which greatly disturb sleep. 

7. Soothing Syrups. Untold trouble, both physical and nerv- 
ous, is bound to follow the giving of soothing syrups. These 
medicines soothe by knocking the nerves senseless and never by 
removing the cause. They contain morphin, opium, cocain, 
heroin, and other drugs which deaden pain, and are most dan- 
gerous to give baby. 



FRESH AIR, OUTINGS, AND SLEEP 221 

DAILY NAPS 

The morning nap from the sixth month on should be from 
two to three hours long, out on the porch, well protected ; while 
the afternoon nap may be from one to one and a half hours 
long with an interval of two or three hours before bed- 
time. The child should be wakened at regular intervals for 
feedings during the day — every three hours until he is six 
months old, and then every four hours. These naps should 
be taken in a cool place — on the porch, on the roof, in the yard, 
under a tree, or on the protected fire escape. 

If the nap is to be taken indoors, then lower the windows from 
the top and darken the room. All children should take daily 
naps until they are five or six years old. 



CHAPTER XXIII 
BABY HYGIENE 

POSSIBLY if all our babies could grow up in a mild, warm 
climate, out of doors, where they were cared for by mothers 
who had nothing else to do but enjoy nature in a garden, their 
babies unhampered by clothes and other conventionalities in- 
flicted upon us by our present standards of living — well, if that 
were our environment, probably this chapter on baby hygiene 
would not need to be written. But realizing that variable 
climatic conditions, the indoor life, and the necessary bundling 
up with clothes, all tend to increase the ever-present danger of 
infection from thickly settled peoples and their domestic pets — 
these facts, together with the further fact that modern social 
conditions make it necessary for some mothers to toil long hours 
— all these influences, I say, considered separately or com- 
bined, make it imperative for us to give thoroughgoing con- 
sideration to the essentials of baby hygiene. The subjects of 
fresh air, sleep, bathing, etc., have been duly discussed in pre- 
vious chapters. 

WATER DRINKING 

As soon as the newborn baby has been washed and dressed, 
before he is put to sleep, he is given two teaspoons of warm, 
boiled water in a sterile bottle with a clean nipple. This is re- 
peated every two hours when he is awake, until he is old enough 
to ask for water himself. This water should contain no sugar, or 
anything else — just clean, boiled water. It is better to give 
this water from a bottle; for in case of enforced weaning, this 
practice of taking his water from a bottle, will have made 
him acquainted with that method of feeding. 

222 



BABY HYGIENE 223 

URINATION 

The baby may pass very little urine during the first day or 
two of his life, but if the warm, boiled water is administered 
regularly, the urine will soon become more abundant. 

As the child nears two years of age, if put to bed at six p. m. 
he should be taken up at ten or eleven to urinate. 

In older children, bed wetting is often corrected by serving 
the last meal not later than four p. m. and not allowing any 
liquids after that hour. 

The physician should be consulted in all instances where the 
habit of bed wetting extends beyond three years. The sub- 
ject will be treated more fully in a later chapter. 

EXERCISE 

A baby pen, lifted up from the floor, well protected at the 
sides, and covered with mosquito bar — if exposed to flies or 
mosquitoes — affords splendid opportunity for exercise. Here 
the little fellow may lay on a well-padded mattress and kick, 
move his arms, and otherwise roll about to his own satisfaction. 
It should not be in the direct sunshine, but rather in a protected, 
somewhat shady place, yet where the air is pure and fresh. 

Much exercise is obtained from the daily cry. Here, the arms, 
legs, hands and feet, as well as the body, are all exercised until 
the "baby is pink. A good rebound of blood is flowing through 
the well-warmed skin, while the baby is greatly benefited by 
such daily exercise. 

Later on, " creeping " is urged, but not forced. With regard 
to standing — he will pull himself up on his feet just as soon as 
nature qualifies him, and so he needs no urging or coaxing 
in this matter. Older children should be encouraged in active 
romping, games, etc., rather than to spend the entire day in the 
more sedentary amusements, puzzle pictures, etc. 

It is a most abnormal situation when a three-, or four-year-old 
child is content to sit quietly all day. There is usually some- 
thing seriously wrong with a child who never soils his rompers, 
who never makes a noise, and who does not seem to enjoy 
normal play and fun. 



224 THE MOTHER AND HER CHILD 

Let the little folks early learn that the home is theirs to enjoy 
and that their little friends are welcome; and thus you may be 
spared such a reproof as one little lad of four unknowingly 
gave his mamma. His little friend was approaching the stairs 
of the play room, when the thoughtless mother carelessly and 
impatiently remarked : " Oh, are you going to bring Ned up- 
stairs? you'll make so much noise." The little host met his 
friend at the top with the words : " They don't want boys in 
the house, we'd better go outdoors." The mother " woke up " 
and arranged a little " party " upstairs for the two husky, 
healthy — and noisy — boys. 

During the creeping days remember that the floor is the 
coolest part of the room, and in the absence of the creeping 
pen, which is " built up " two feet above the floor, extra cloth- 
ing should be put upon the child while on the floor. During the 
damp days of early spring and the cool days of late fall, as well 
as on the bleak days of winter, baby is better off if he is kept 
off the floor. It is a fine plan to put a number of table boards 
on top of the springs of the baby's bed; in this way a sort of 
pen is produced which is high above the cold floor and the baby 
is content to spend much of his time in this little pen, happy 
with his playthings. 

KISSING THE BABY 

We most strongly protest against the haphazard, promiscuous 
kissing of babies. Many forms of disease, such as tuberculosis, 
syphilis, diphtheria, influenza, common colds, etc, may be car- 
ried to the child in this way. 

The baby, notwithstanding his attractiveness, his beauty, and 
his grace, should not be overfondled. Kissing the hand is not 
much better than the mouth, for the hand quickly finds its way 
to the mouth. If it be necessary to kiss a baby, then let the 
kissing be done on the back of the neck or on top of his head, 
but never on the face or hand. 

SUCKLING HABITS 

There came into the office one day a woman forty or more 
years of age, whose mouth was markedly disfigured, and on my 



BABY HYGIENE 225 

inquiring as to the probable cause she said : " Doctor, it is the 
result of sucking my thumb when I was a mere child, too young 
to know better, and every time I look into the glass, which I 
assure you is only when I am compelled to, I curse my parents 
for not breaking me of that habit." The indulgent parents were 
hated and despised for neglecting their duty, because of the 
disfigurement which resulted from this unrestrained habit of 
early childhood. 

Thumb sucking, finger sucking, or pacifier sucking, are all 
filthy habits, and should be early discouraged. To aid in over- 
coming the habit of sucking the thumb or biting the finger- 
nails, the ends of the fingers and edges of the nails may be 
painted with a solution of aloes or quinine. In extreme cases, 
a splint may be placed on the anterior bend of the elbow, thus 
preventing the possibility of raising the hand to the mouth. 

The " sugar teat " of our mother's generation has passed, as 
has also the " mumbling " of food for the young child ; we no 
longer give the babies concentrated sugar, nor do we " chew " 
our children's food at the table. 

Extreme cases of chalk or dirt eating have been noted; such 
tendencies are decidedly abnormal, and require medical attention. 

KEEP BABY WARM 

Much colic and fretfulness may be avoided if baby is kept 
warm. The finger tips are a good thermometer, for if they are 
warm the feet usually are. " Bundling " is unnecessary, but 
careful attention should be paid to keeping the feet and hands 
warm without making the child sweat; that is an art, and all 
mothers should attain it. An extra flannel wrapper and a pair 
of heavy wool booties in the winter are good warmth producers. 
Cotton flannel petticoats should be replaced by warm woolen, 
ones, and when the baby begins to get about on his hands and 
knees a pair of loosely fitting wool tights, made from discarded 
woolen underwear are of inestimable comfort and value. In 
the effort to avoid draughts and body chilling, ever bear in mind 
baby's need of fresh air and the dangers of sweating, for the 
sudden cooling of a sweating child is a forerunner of pneu- 
monia, cold catching, diarrhoea, and other troubles. 



226 THE MOTHER AND HER CHILD 

baby's temperature 

During early infancy, baby's temperature sometimes varies 
greatly; for instance, a rectal temperature may register 97.5 or 
100.5 F. while the child may be in perfectly good health. 

The baby's temperature should be taken at the rectum — which 
should normally register 99.5 F. This temperature, as stated 
above, may register 100.5 F., with no other symptoms of ill- 
ness. In taking rectal temperature the thermometer should re- 
main in place two minutes. 

The groin is the next best place to take the temperature ; here 
the thermometer should remain five minutes, and the registry 
is usually a degree lower than that of the rectum. 

The baby's temperature usually is a good guide to the severity 
of any illness. In case the temperature runs above 101 F. the 
physician should always be notified and his orders carefully fol- 
lowed. Slight causes often produce a "high temperature of 
103 to 105 F. for a short time; but such a temperature of 
long duration means serious trouble and demands expert 
advice and attention. Abnormal temperature will be more fully 
considered in that section of this work entitled " Common Dis- 
orders of Infancy." 

BABY BOUNCING 

The common custom of bouncing or trotting baby on the knee 
is a harmful one. The young and growing nervous system of 
the child is decidedly injured by this constant jolting and jig- 
gling, to say nothing of the " spoiling " effects of this practice. 
There is a vast difference between the sensitive nervous system 
of the infant, with its liability to shock and disturbances, and 
that of the settled and developed nervous system of an adult. 
The strength of the mother or nurse is so great that the jarring 
not only often causes indigestion and vomiting in the infant, 
but sometimes also lays the foundation for " wrecked nerves " 
in later life. 

The tossing of baby in the air comes in for the same con- 
demnation. Baby is not "our plaything," and must not be 
bounced and tossed about like a rubber ball. 



BABY HYGIENE 227 

CARRIAGES AND GO-CARTS 

The first carriage should be roomy and comfortable. The bed 
should be thirty-three inches long and fourteen inches wide, and 
should be twenty-eight or thirty inches from the floor. The 
wheels should be rubber tired. The cover should be a good sized 
hood containing a dark lining, and provided with a wind shield. 
This dark lining creates a neutral shade for the eyes and pro- 
tects them from the glare of the sun and the bright skies. 

The bed of the carriage should be soft and warm; and, with 
the size before mentioned, there is ample room for the " tuck- 
ing in " with warm blankets, which are first spread out on the 
bed and then the baby placed into the blanket, after which it 
is brought up and over him. 

The folding go-cart and the small carrying-basket are to be 
used only in an emergency. They are convenient in traveling 
or shopping for the mother who has no maid or caretaker with 
whom to leave the baby; but they are not satisfactory pleasure 
vehicles, neither should the baby be left to sit fastened in one 
of these carts for any great length of time. 

The mattress of the carriage should be of hair, while needed 
warmth may be secured by the use of a thick, light-weight 
woolen blanket, placed under the child and brought up and 
around him. 

A top covering for the carriage must have washing or dry 
cleaning qualities. A crocheted afghan, a washable embroidered 
cover, or a firm silk puff, are good covers. The one thing to be 
remembered is that everything about the carriage soils readily, 
and if this thought enters into the selection of fabrics, you will 
not be disappointed when cleaning time comes. 

The carriage pillow should be of down, except in the very hot 
months, when hair is preferable. Simple, easily laundered slips 
may be made from two men's-size handkerchiefs. 

BOW LEGS 

Particularly in boys and men, bow legs are not only awkward 
but are a noticeable deformity ; even the little folks notice them 
and often remark about it, as did one child who sat profoundly 
eyeing a very important visitor who stood before the cheerfully 



228 THE MOTHER AND HER CHILD 

lighted grate warming himself. The little fellow suddenly ex- 
claimed, " Oh, Mister, look out ! You're warping." Such a 
painful experience might have been saved this distinguished 
gentleman had his mother or caretaker not urged his standing 
too soon ; and at the same time had fed him on the proper food, 
so as to avoid " rickets." The ossification or hardening of the 
bones of the legs continues all through childhood and is often 
interfered with by improper feeding during the first two years 
of life. Urging the little people to stand too early is to be dis- 
couraged. Nature prepares them for it when the right time 
comes; which time varies — thin children standing and walking 
usually much earlier than heavy children. 

LIFTING THE BABY 

A very young baby should be lifted from his bed by grasping 
the clothing below the feet with the right hand, while the left 
hand slips underneath the back and with spreading fingers sup- 
ports the neck and head. It is then raised upon the left arm. 
During the early months the entire spine must be supported in 
this manner (See Fig. 6). In grasping a baby under the arms 
or about the waist, undue pressure is made upon the abdomen 
and chest. Serious injury often follows the careless lifting of 
the older child by his wrists or hands. The throwing or whirling 
of the older children by the arms is strongly condemned. Dis- 
locations have followed such careless so-called fun. 

PREVENTION OF FALLS 

In the selection of the high chair, care should be given to the 
possibility of overturning. Fortunately, baby's bones are only 
partially ossified, else he would sustain many fractures in the 
frequent falls and bumps. When we pause to consider the 
thoughtless manner in which many babies are left on beds and 
in unguarded chairs, it is not strange that they fall so often. 

Open windows must be carefully protected by well-fastened 
screens or by slats of wood. Beds afford a good place for a 
romp or play, but high-backed chairs should be placed at the 
side to prevent a fall. A strap across the waist should be fast- 
ened to the sides of the carriage to prevent falling out. Every- 



BABY HYGIENE 229 

thing possible should be done to prevent falls. Outdoor ham- 
mocks are exceedingly dangerous for the baby. Never leave a 
child in one unguarded. A little caution, a large amount of 
common sense — the " good use of brains " — will prevent 
scars and other lifelong deformities. 

THE BABY'S BREASTS 

Never allow anyone to manipulate or " break down " a swollen 
breast in a girl or boy baby during the first week or two. This 
swelling occurs often and should not be interfered with. A hot 
compress of boracic acid solution may be applied, after which 
a piece of sterile gauze should be placed over the swollen part 
and held on by a muslin bandage. Secure medical attention if 
the swelling does not go down in a day or two. 

VISITING 

Unless absolutely necessary, babies should not be taken on 
trains and street cars; nor should they take long journeys into 
the country to attend " reunions." Infections accompany crowds, 
and baby is far better off at home, in the quiet of his natural 
surroundings, than he is in the dust, closeness, and bustle of 
illy ventilated cars, streets, shops, movies, or even at church. 
Many an infant has been sacrificed by a train journey to " show 
him off" to the fond grandparents; scores of babies acquire 
whooping cough at the movies ; and many a baby has nearly 
lost his life by catching measles, scarlet fever, or diphtheria at 
church; while the only thing accomplished by the church ex- 
periment was the spoiling of the entire service by its fretful, 
tired cry — the infant's only means of protest. 

THE RUNABOUT BABY 

" Runabouts " are the little folks between the age of one and 
three years, and they require good care, good feeding, and warm 
and comfortable dressing. 

In general, they need the same fresh air, daily outings, and 
daily naps of the younger child. Their hands need washing 
oftener, and their clothing, which is usually a play romper, 
should be either of white or fast colors that it may be most thor- 



230 THE MOTHER AND HER CHILD 

oughly boiled, thus getting a good disinfection. Their eyes, nose, 
and ears, as well as the genital organs, all require the most rigid 
daily cleanliness. 

The " bugbear " second summer need not be feared by the 
mother who takes particular care to see that: 

1. The drinking water is boiled or distilled. 

2. The orange is not overripe. 

3. The banana is not underripe or overripe and is not eaten 
in chunks. 

4. The milk is fresh and pasteurized. 

5. The baby does not eat candy, ice cream, or other forbid- 
den foods. 

6. The baby's bowels move daily. 

7. He does not remain dirty. 

8. He naps daily. 

9. He is protected from dust, flies, flees, and mosquitoes. 
10. He does not go visiting, to church, shops, or " movies." 

The second summer is no harder than the first, as good clean 
water, easily digested foods, and good general hygiene are all 
a baby needs at this time. A large army of little folks grow up 
in spite of the little care they get and the place in which they 
live. Did they not possess good vital resistance, sound nerves, 
and good digestion, the children of the " slums " and of the 
" ghetto " would quickly succumb to their unhygienic sur- 
roundings. 

TOYS 

In selecting toys for the infant, it must be borne in mind that 
they will be put to the mouth, and hence they should not be: 

1. Toys with sharp points. 

2. Small enough to swallow, or to push into the nose. 

3. Covered with hair or wool. 

4. Glass that is easily broken. 

5. Painted toys. 

6. Toys that may be taken apart and the small parts swallowed. 

7. Paper books that may be chewed or torn. 



BABY HYGIENE 231 

Bear in mind that babies are easily amused with such simple 
toys as : 

1. A half-dozen clothes pins. 

2. An aluminum pan and a spoon. 

3. Rubber toys (easily washed). 

4. Celluloid dolls, ducks, and other floating toys. 

5. Blocks. 

6. A large rubber ball. 

The older children have wonderfully good times out of doors 
with a spade, a cart, and the sandpile. Boys most thoroughly 
enjoy a track with its engine and cars, switches, etc. They build 
sham fortifications, truly works of art, with their blocks, while 
the girls are happiest with dolls and household sets. However, 
occasionally we meet a mother who has a girl who is really a 
boy in her tastes for toys, and so we say to that mother: give 
the little girl the desire of her heart; if it's a train instead of a 
doll, or a toy gun instead of a doll's trunk, well and good, let 
her have them. What we want are free and easy, natural, chil- 
dren. They are much more likely to have good nerves, clean 
thoughts, sound digestion, and equalized circulation. 



CHAPTER XXIV 
GROWTH AXD DEVELOPMENT 

THE newborn baby comes into the world in an absolutely 
helpless condition and completely unconscious of his sur- 
roundings. He unconsciously performs certain acts, such as 
opening his eyes, crying, urination, movement of the bowels, 
and even nursing of the breast; but there is probably no dis- 
tinct voluntary action connected with any of these acts. All 
of his senses at birth are practically dormant, but as the days 
and weeks go by, they begin to awaken. 

SPECIAL SENSES 

The baby cries, but the tears do not actually flow over the 
lids until he is three or four months old, and while the baby 
may fix his eyes upon objects and distinguish light from dark- 
ness, he will not wink nor blink when the finger is brought close 
to the eye. Vision is probably not complete until the beginning 
of the third month. 

Infants are said to be deaf for the first twenty-four to forty- 
eight hours after birth, and some authorities hold that they are 
deaf for several days. 

Taste is early developed, as a newborn baby will often re- 
peatedly show a desire to taste sweet things, while if sour or 
bitter things are put to the tongue, it shows its displeasure. 

HAIR AXD SCALP 

The newborn baby usually comes into the world with a good 
head of hair, but the end of the first or second week witnesses 
the falling out of much of this hair, and falling may continue 
for even another week or two. The hair is often worn ofY on 
the back of the head because of constant friction upon the 
pillow. 

232 



GROWTH AND DEVELOPMENT 233 

Children differ greatly in the growth of hair. Some of them 
come into the world with heavy hair, and others lose it quickly 
and remain nearly bald-headed until after the first year. 

As the second hair grows in, it is usually lighter than it was 
at birth and lighter than it will be later in life, as the hair has 
a tendency to grow darker as the years go by. 

The scalp should receive the care already mentioned. As the 
hair comes in it should be shampooed once in two weeks and 
brushed often, making it healthy and vigorous. 

MISSHAPEN HEADS 

It is wise to turn the baby first on one side and then on the 
other and not allow him to sleep night after night on one side 
of his head. The newborn head may be misshapen by laying 
the child constantly on one side, and the ear may be misshapen 
if it is allowed to curl under or become pressed forward. Mark- 
edly protruding ears may be partially corrected by having the 
child wear a well-ventilated cap made for the purpose. 

THE SALIVA 

Many mothers think that the presence of drooling or the ex- 
cessive flow of saliva is associated with teeth cutting. While 
it may be associated with the teeth, this is not usually the case ; 
it is more probably due to the beginning of a new function of 
secretion. The newborn baby has only enough saliva to fur- 
nish moisture for the mouth, and not until the age of four 
or five months does saliva really flow, and since the teeth 
appear a bit later we often confuse the institution of a new 
secretion with the oncoming teeth. 

SENSATIONS AND RECOGNITION 

The young baby manifests a number of sensations early in 
its career. Hunger and satisfaction as well as comfort and 
discomfort seem to be recognized by the little fellow. He 
early learns that the approach of someone when he cries 
usually means that he is to be taken up, and he usually 
ceases crying as soon as he is taken up. He early manifests 
a sense of comfort when he is cuddled; there also is early 



234 THE MOTHER AND HER CHILD 

present a manifestation of the desire to sleep, and the satisfy- 
ing pleasure of a drink of water. 

At the age of three months he has recognized many things 
such as the light or a bright object. He distinctly recognizes 
his mother and often smiles at her approach. He recognizes 
his hands at four months, and now begins to recognize other 
members of the household aside from his mother. Even as 
early as one month, he may smile at his mother. At two months 
of age he will often smile at other members of the family. He 
laughs out loud or chuckles during the fourth or fifth month. 
But, on the whole, he must be considered as just a little animal 
whose greatest needs are to have his appetite and thirst satisfied, 
his little body clothed, and his little nerves put to rest — to sleep. 

SITTING ALONE 

At four months the normal baby will hold up his head; and 
if he is supported at the back with a pillow, he will sit erectly 
— holding his head up — at six months ; while at eight months 
or not later than nine, the normal child should sit alone on the 
floor with no support. Later in the ninth month he often mani- 
fests a desire to bear his weight upon his feet. Care is here 
urged that the mother protect the little fellow at this time 
and not allow him to rest his weight upon his feet but a 
moment or two at a time. 

He will reach for a ball suspended from the top of his 
carriage or bed as early as the fifth month. About this time 
he discovers his toes while in his bath. He will handle a 
rattle at six or seven months, and shows delight in such toys. 

DENTITION 

In both the upper and lower jawbones of the newborn 
infant there are hidden away in snug little cavities two sets 
of tiny teeth; the first set, or milk teeth, and the second set, 
or permanent teeth. These rudimentary teeth grow as the 
baby grows and push their way up or down from the jaw- 
bones until they finally make their appearance through the 
gums. The milk teeth appear in a definite way and in five 
definite groups. 



GROWTH AND DEVELOPMENT 235 

There should be no physical disturbance at the appearance 
of the teeth, which is a physiological process, and it is to be 
deplored that all of the ills of babyhood are laid upon the 
teeth with the careless remark : " Oh, its his teeth ! " Many, 
many illnesses are neglected because our inexperienced mother 
has been told that she can expect " anything to happen when the 
baby is cutting its teeth." Now, it is true that the babies of 
many families do have trouble in cutting their teeth, but the 
majority of babies cut their teeth comfortably and the first 
knowledge anyone has of it is the appearance of the tooth itself. 
As the teeth push their way nearer the surface of the gums, 
there is a broadening and a hardening of the gums themselves, 
and it is the exception rather than the rule that the baby needs 
any help in cutting his teeth. 

Usually by the time the baby is seven months old it has two 
central teeth on the lower jaw (the central incisors), which 
constitute the first group. The second group of teeth to appear 
is the four upper central teeth which are all through by the 
time the baby is twelve months old, and are often through at 
ten months. Then there is a pause of from one to three months 
before the next teeth appear — the four anterior molars. As 
these four anterior molars come in, the two lateral incisors 
appear on the lower jaw, which now gives us, by the time the 
baby is fourteen or fifteen months old, four central teeth upper, 
four central teeth lower, and the four anterior molars, which 
make twelve teeth. 

Another pause of two or three months and then we get the 
four canine, which fill in the space between the first molars and 
the front teeth. The canine on the upper jaw are commonly 
known as the eye teeth, while the canine teeth on the lower 
jaw are spoken of as the stomach teeth. This brings us to the 
age of eighteen to twenty-four months, when there is still 
another pause of two or three months, after which time the 
big teeth or the four posterior molars appear, which completes 
the first set of twenty teeth — the milk teeth. When baby is 
twenty months old the milk teeth are often all in. The complete 
set should appear not later than the thirtieth month. 

During the life of the milk teeth the child should be taken 



236 THE MOTHER AND HER CHILD 

to the dentist at least once a year, better once in six months, 
for all defective teeth must be properly and promptly cared for. 
Inexpensive but sanitary fillings should be placed in all decayed 
teeth, for the roots of the first teeth are very soft and infec- 
tion readily spreads to the jaws and the permanent teeth and 
serious trouble often begins thus early. 

If dentition is seriously delayed, investigation should be 
started concerning the general condition of the child, for this 
delay often accompanies ill health. 

When the child is six years old, the mother should be watch- 
ful, for it is at this time that the first permanent teeth appear 
just behind the last molar of the milk teeth. They do not 
replace any of the teeth present, and many times they come 
through and decay without receiving any attention. It is sel- 
dom necessary to assist these milk teeth as they come through 
the gum, and should the gums become highly colored and 
swollen it is not wise to lance them, for if the teeth are not 
ready to come through immediately, the gum only toughens 
the more and makes the real cutting still more painful. 

This is the time to cut down the baby's food as well as to 
look for other digestive disturbances, for the number of stools 
may increase and vomiting may occur, and by reducing the 
quantity and quality of the food and encouraging abundant 
water drinking, much trouble may be avoided. Under no cir- 
cumstances urge the baby to eat when he refuses his food, 
when the gums seem swollen and red during the teething time. 
You will find that he will enjoy orange juice, pineapple juice, 
or prune juice. All of these digestive symptoms are simply 
the result of " feeling bad, " and if heavy food or his regular 
feeding is greatly diminished he will get along much better 
than if fed his regular allowance of food. 

APPEARANCE OF THE TEETH 

The normal child has: 

Six teeth at one year. 

Twelve teeth at one and one-half years. 

Sixteen teeth at two years. 

Twenty teeth at two and one-half years. 



GROWTH AND DEVELOPMENT 237 

When the child is six years old the first permanent tooth 
appears just back of the last of the milk teeth. By the time 
he is seven, the four central teeth, two above and two below, 
are out and the new ones begin to appear. The order of their 
appearances is as follows: 

Four first molars 6 years 

Four central incisors 7 years 

Four lateral incisors 8 years 

Four first bicuspids 9 to 10 years 

Four second bicuspids 10 to 11 years 

Four canines 11 to 13 years 

Four second molars 12 to 15 years 

Four third molars 17 to 25 years 

DENTAL SUGGESTIONS 

A better plan than to lance swollen gums is to rub them 
gently with ice wrapped in a soft cloth, or to dip the finger in 
ice water and rub the gums — this often gives the baby much 
relief. 

Often the baby finds comfort in biting on an ivory ring, but 
the utmost care must be used in keeping it clean and avoiding 
contamination by allowing it to drop on the floor. 

Convulsions are never the symptoms of teething. Consult 
a physician at once, as such seizures probably spring from 
causes other than teething. 

Cleansing of the teeth should be carried out systematically 
every morning by means of a piece of cotton which has been 
dipped in a boric-acid solution or a solution of bicarbonate of 
soda (common baking soda). A soft brush may be used for 
cleansing, and when there are particles of food between the teeth 
they should be removed by strands of waxed floss. 

Throughout life, frequent visits should be made to the den- 
tist; during early childhood days he should be on the lookout 
for symptoms which indicate deformity — narrow jaws and 
other conditions which affect the permanent teeth. During 
adolescence and adult life the teeth should be examined every 
six months and cleansings of the mouth should become a part 
of the daily toilet. 



238 THE MOTHER AND HER CHILD 

THE WEIGHT 

During the first year, nothing gives us so much information 
concerning the child's general well-being as the weight. Such 
a record will not only enlighten the mother concerning the 
development of the child, but the grown-up child appreciates 
the record and preserves it along with the other archives of 
babyhood days. Every Sunday morning, when the father is 
at home, the baby should be weighed and an accurate record 
kept. It is important that the baby be weighed each time in 
the same garments — shirt, band, diaper, and stockings — for 
every ounce must be accounted for. 

Until the baby is five or six months old he should gain from 
four to eight ounces a week. Anything short of this is not 
enough and should be reported to the physician. After six 
months the gain is about a pound each month. This varies 
somewhat; possibly during the tenth and eleventh month the 
gain is lessened, but by the close of the first year the baby 
should have trebled its birth weight. 

Dr. Griffith gives us the following very interesting bit of 
information concerning the weight of boys and girls after the 
first year, and to him also belongs the credit for the accom- 
panying table showing the growth, height, and weight of the 
child up to sixteen years of age. 

After the first year we notice that, taking it all together, there is 
a gradual increase in the number of pounds and a decrease in the 
number of inches added yearly, four inches being gained in both 
the second and third years, three inches in the fourth and fifth years, 
and after this two inches a year. The gain in weight is four pounds 
yearly from the age of three to that of seven years, then five, then 
six, and then about nine pounds. It sometimes happens that at about 
the age of nine in girls and eleven in boys there is almost a cessation 
of growth for a short time. Later, at about twelve years, girls take 
on a particularly rapid growth, and decidedly exceed boys of the 
same age in weight, and sometimes in height also. At fifteen or 
sixteen years the rapidity of growth in girls, both in weight and 
height, will be greatly diminished, while boys of this age will often 
begin to develop very rapidly, and will soon materially exceed the 
other sex in both respects. 



GROWTH AND DEVELOPMENT 



239 



TABLE SHOWING GROWTH IN HEIGHT AND WEIGHT 



Age. Height. 

Birth 19 inches. 

1 week 

2 weeks 

3 weeks. 

1 month 2oy 2 inches. 

2 months. . . .21 

3 months. . . .22 

4 months. . . .23 

5 months 2^/2 " 

6 months. .. .24 

7 months. .. .24^ " 

8 months . ... 25 

9 months 25^ " 

10 months. . . .26 

11 months 26^ " 

1 year 27 

2 years 31 

3 years 35 

4 years ZIV2. " 

5 years 40 

6 years 43 

7 years 45 

8 years 47 " 

9 years 49 

10 years 51 

ii years S3 

12 years 55 " 

13 years 57 

14 years 59 

15 years 61 " 

16 years 63 " 



Weight. 
7 lbs. 8 oz. 
7V2 " 



m 

10M 

1234 
mi 

15 
m 

17V4 
1854 
1834 
1934 

20^4 
21^4 

27 

32 

36 
40 

44 
48 

53 
58 

64 

70 

79 

88 
100 
109 
117 



10^ " 

2 " 



Gained 1 oz. a day; 
7 oz. a week. 



"\ f Gained 34 oz. a day; 
J I 5^2 oz. a week. 



Double original weight. 
Gained ^3 oz. a day; 
4^ oz. a week. 

Gained ^4 in. a month. 
Gained about 1 lb. a month. 

Treble original weight. 

J- 4 Gained 4 in. a year. 

Double original length. 
J Gained 3 in. and 4 lbs. a 
I year. 

"1 J Gained 2 in. and 4 lbs. a 
J I year. 



}{ 



Gained 
year. 



in. and 5 lbs. a 



J Gained 2 in. and 6 lbs. a 
I year. 



J Gained 2 inches and about 
I 9 lbs. a 3'ear. 



240 



THE MOTHER AND HER CHILD 



GENERAL DEVELOPMENT 

The accompanying illustration (Fig. 14), taken from Dr. 
Yale, represents the developmental changes at one, five, 
nine, thirteen, seventeen, and twenty-one years. Each figure 
is divided into four equal parts, and as we watch the develop- 
ment from the baby who at one year, as Dr. Yale says, is four 
heads high, at the age of twenty-one the legs and the trunk have 
much outgrown the growth of the head, so that at this age the 
head is only two-thirteenths or less of the whole length of the 




5 9 13 17 

Fig. 14. Developmental Changes 



body. The legs have grown more rapidly and equal one-half 
the entire body length. The trunk has not kept pace with the 
legs, for as you will see from the diagram the line reaches 
the navel of the child in one year, while in the adult it is much 
lower. The rapid growth of the legs is accomplished after 
nine years of age. 

The proportions of the head, chest, and abdomen are exceed- 
ingly important in the growing child. At the end of the first 
year the head, chest, and abdomen are about uniform in cir- 
cumference. The head may measure one-fourth of an inch 
more, but the chest and abdomen should both measure eighteen 



GROWTH AND DEVELOPMENT 241 

inches in circumference at this time. Should the head or the 
abdomen be two inches larger than the chest; the attention 
of the physician should be called to it, for either are indicative 
of conditions that should be carefully investigated. 

NORMAL BREAST WEANING 

As a general rule the normal, healthy, breast-fed baby is 
given a feeding of a bottle each day after he is ten months 
old. These bottles are increased in number until, by the time 
the baby is a year old, he is gradually weaned from the breast. 
Should the ninth month of baby's life arrive in the hot summer 
months we urge the mothers to continue breast feeding, with 
possibly the addition of some fruit juices, as noted elsewhere, 
until early autumn. Under no circumstances should the baby be 
weaned and compelled to use cow's milk during the season of 
the year when the risks of contamination are greatest. If the 
baby is nursed up to the close of his first year he hardly need 
be trained to use the bottle, but may take his food from a cup. 
From one to two months should always be consumed in wean- 
ing the baby, unless sudden weaning is necessitated by ill 
health, as noted elsewhere. The baby should have, if possible, 
from thirty to forty days to accustom himself to cow's milk 
exclusively. 

If the child is weaned slowly there should be no trouble with 
the breasts, but in the instance of sudden weaning the mother 
should restrict her liquids, put on a tight breast binder, and 
for a day or two should take a dose of a saline cathartic, 
which will assist in taking care of the liquids and thus decrease 
the secretion of milk. 

NORMAL BOTTLE WEANING 

If the bottle food is agreeing with the baby he should be 
allowed to use it up to the end of the first year when he will 
be given whole milk with possibly the addition of a little lime 
water. We see no reason why the child should give up his 
bottle during the second year unless other food is refused — 
unless he will not accept other food than from his bottle — and 
if you are convinced that he has formed the " bottle habit, " 



242 THE MOTHER AND HER CHILD 

then the milk should be put into a tiny cup or glass, and he 
should learn to sip it along with his solid foods; but if he takes 
his other foods without any hesitancy, then we know no reason 
why he should not take his milk in this comfortable manner 
from his bottle at least two or three feedings each day. 

If you desire to wean him from his bottle, serve the first part 
of it with a spoon from a cup or glass and then give him the 
remainder in the bottle. The beautiful picture of a big, robust 
baby lying on his back, knees flexed, both hands holding his 
beloved bottle still lingers in my mind as one of the pleasant 
memories of my lad's babyhood days, and at the close of the 
second year, when the beloved bottle was left behind, I believe 
I missed something as well as did the lad. 

I recall no difficulty with his taking the food from a cup. 
The success of all normal weanings is due entirely to the fact 
that it is done gradually and slowly, and under no circum- 
stances should it be roughly and abruptly attempted — partic- 
ularly in case of the bottle feeding. 

TRAINING THE BOWELS AND BLADDER 

Reference is made to this subject in another part of this 
book — where we went into the detail of keeping the daily record 
of these physiological occurrences — and it was found that the 
bowels moved and the bladder was emptied at about the same 
time each day. Any mother, caretaker, or nurse, who will take 
the time to keep a daily record of the hours of defecation and 
urination, will observe the time carefully and will catch the 
child on nearly every occasion before an accident occurs. Often 
as early as four months the bowels will move in an infant's 
chamber at regular times each day. The nurse or mother 
places this receptacle in her lap and holds the child gently and 
carefully upon it. A little later it can be made to sit on a spe- 
cial chair prepared for the purpose, and at eight or nine months 
by careful training the urination can be controlled, and by the 
end of the first year the diapers ought to be discontinued. 

If the child has not learned to control the bladder by the 
age of two years, medical attention should be called to the 
fact and remedial measures instituted. 



GROWTH AND DEVELOPMENT 243 

baby's speech 

The baby should begin to talk at one year. He early learns 
to say " mamma " and " papa," and gradually adds nouns to 
his vocabulary, so that at eighteen months the normal child 
should have a vocabulary of one hundred to one hundred and 
fifty words. As he nears the two-year mark, he has acquired 
a few simple verbs and he can possibly put three words together, 
such as, " Willie wants drink." Pronouns come in late, as we 
all recall that the young child usually speaks of himself by 
his own name. 

Children are born mimics. If you talk baby talk to them, 
they will talk baby talk back. For instance, a well known 
author told us just the other day that for many years no other 
name was given to the sewing machine in his house but the 
word " mafinge," and not until he went to school did he cor- 
rect the word " bewhind," for in the nursery he learned the 
line " wagging their tails bewhind them." Baby talk is very 
cunning, and often the adult members of the family pick it up 
and keep it up for years, and only when they are exposed in 
public, as one mother was on a suburban platform by her 
four-year-old lad shouting, " Mamma, too-too tain tumin, too- 
too tain tumin," do they sense their responsibility and realize 
how difficult it is to form new habits. This poor mother tried 
in vain to have her little fellow say, as did another little lad 
two and one-half years old, "Mother, the train's coming; let's 
get on." 

Many words of our beloved language at best are hard to 
understand; so let us speak correct English to the little folks 
and they will reward us by speaking good English in return. 

If at two years the child makes no attempt at speech, sus- 
picions should be aroused concerning mutism or other serious 
nervous defects. Medical advice should be sought. 

DEFECTIVE SPEECH 

All guttural tones which may be occasioned by adenoids or 
enlarged tonsils, all lisping, stuttering, or defective speech of 
all words should be taken in hand at the very start, as they 



244 THE MOTHER AND HER CHILD 

are usually overcome by constant repetition of the correct 
manner of speaking the particular word in question. Children 
of defective speech need special training, and should in no way 
be allowed rapidly to repeat little nursery rhymes, as oftentimes 
this rapid repetition of rhymes by a child with hereditary 
nervous defects may occasion stuttering or stammering later on. 

CALISTHENICS 

Special exercise should not be forced upon young children. 
Physical culture, along with many other things intended for 
sedentary adults, should never be forced upon little folks who 
get all of the exercise they need in the many journeys they 
take building their blocks, sailing their boats, tearing down 
imaginary houses, making imaginary journeys — from morn- 
ing until night the little feet are kept busy — never stopping 
until the sandman comes at sleepy time. Do not yourself 
attempt to stimulate a child who seems backward. Consult your 
physician. You had much better put a child out to grow up 
in the yard by himself with his sandpile than to force calis- 
thenics or advance physical training upon him. 

BOW LEGS AND WALKING 

Do not attempt to hasten nature in aiding the child to walk. 
Let him creep, roll, slide, or even hunch along the floor — wait 
until he pulls himself to his feet and gradually acquires the art 
of standing alone. If he is overpersuaded to take " those cute 
little steps " it may result in bow legs, and then — pity on him 
when he grows up. Sometimes flat foot is the result of early 
urging the child to rest the weight of the body upon the unde- 
veloped arch. A defect in the gait or a pigeon toe is hard to 
bear later on in life. A certain amount of pigeon-toeing is 
natural and normal. If the baby is heavy he will not attempt 
to walk at twelve months. He will very likely wait until four- 
teen or fifteen months. The lighter-weight children sometimes 
walk as early as eleven months, but they should all be walking 
at eighteen months, and if not, it is usually indicative of back- 
ward mentality. 

If the training of the bowels and bladder will replace the 



GROWTH AND DEVELOPMENT 245 

diapers with drawers, the baby will attempt to walk sooner than 
when encumbered with a bunglesome bunch of diaper between 
the thighs. The little fellow runs alone at sixteen months and 
thoroughly enjoys it, and the wise mother will pay no attention 
to the small bumps which are going to come plentifully at this 
particular time. 

SUMMARY OF BABY'S DEVELOPMENT 

He discovers his hands at three or four months. At six 
months he sits alone, plays with simple objects, grasps for 
objects, and laughs aloud from the third to the fifth month. 
He says " goo goo " at four or five months. At one year he 
should stand with support, listen to a watch tick, follow mov- 
ing objects, know his mother, play little games, such as roll- 
ing a ball, should have trebled his birth weight, and have at 
least six teeth, and should use three words in short sentences. 
At eighteen months he should say " mamma " spontaneously, 
walk and run without support, should have quite a vocabulary, 
should be able to perform small errands like " pick up the book," 
and should have twelve to sixteen teeth. At two years he 
should be interested in pictures, able to talk intelligently, and 
know where his eyes, nose, mouth, hands, and feet are. At 
three years, he should enumerate the objects in a picture, tell 
his surname, and repeat a sentence with six words. 

In the case of a premature baby or a very delicate child, or 
as a result of a prolonged illness or a very severe sickness, 
such as spinal meningitis, the time of these mental and physi- 
cal developments may all be postponed, while rickets, which 
will be spoken of later, is often the cause of late sitting, late 
standing, and late walking. 

DIET AFTER THE FIRST YEAR 

Milk is the principal article of diet during the second year. 
It should be given with regularity at distinct intervals of four 
meals a day. It may be given from the nursing bottle, unless 
the child has acquired the bottle habit and refuses to eat any- 
thing else but the food from his bottle, in which case it should 
be given from a cup. Beginning with the sixth month, aside 



246 THE MOTHER AND HER CHILD 

from his milk, be it breast milk or bottle milk, he is to be 
given orange juice once each day as well as the broth from 
spinach and other vegetables. This is necessary to give the 
child certain salts which are exceedingly essential to the bottle 
baby. 

At the close of the year when he is taking whole milk he 
should be given arrowroot cracker, strained apple sauce, prune 
pulp, fig pulp, mashed ripe banana (mashed with a knife), a 
baked potato with sauce or gravy (avoiding condiments), and 
a coddled egg. Fruit juices may be added to the diet, such as 
grape, pineapple, peach, and pear juice. Later in the second 
year he may be given stale bread and butter, and for desserts 
he may have cup custard, slightly sweetened junket, and such 
fruit desserts as baked apple and baked pear. 

We do not think it is necessary to give children much meat 
or meat juices. We appreciate that there is a diversity of 
opinion upon this subject, but we do not hesitate to say that 
in the families where meat is little used, the children seem to 
grow up in the normal manner with sound healthy bodies, 
sometimes having never tasted it. When meat is used, it should 
be well cooked to avoid contamination with such parasites as 
tapeworm and trichina; it should also be well chewed before 
swallowing, as many of the intestinal disturbances of the older 
children are due to the swallowing of unmasticated food such 
as half-chewed banana, chunks of meat, rinds of fruit, and the 
skins of baked potatoes. 

Let the children's diet be simply planned, well cooked, thor- 
oughly masticated, and above all things have regular meal 
hours, and no " piecing " between meals ; and if the mother 
begins thus early with her little fellow, she will be rewarded 
some later day by hearing him say to some well-meaning neigh- 
bor, who has just given him a delicious cookie or a bit of 
candy : " Thank you, I will keep it until meal time." Chil- 
dren learn one of the greatest lessons of self control in follow- 
ing the teaching that nothing should pass the lips between 
meals but water or a fruit -ade. Children in the second year 
require four meals a day, one of which is usually only the 
bottle or a cup of milk. These meals are usually taken at six, 



GROWTH AND DEVELOPMENT 247 

ten, two, and six in the evening. Oftentimes this early six 
o'clock meal is just a bottle or cup of milk, as may also be the 
evening meal. 

CANDY 

Now, a word about candy. Pure candy is wholesome and 
nourishing. It is high in calorific value, and children should 
be allowed to have it if it does not enter the stomach in solu- 
tions stronger than ten or fifteen per cent. We can see at a 
glance that chocolate creams, bonbons, and other soft candies 
should never be given to children. Candies that they can 
suck, such as fruit tablets, stick candy, sunshine candy, and 
other hard confections that are pure, and free from mineral 
colorings and other concoctions such as are commonly used 
in the cheaper candies, may safely be given at the close of 
the meals — but never between meals. 

All such articles as tea, coffee, beer, soft candies, condi- 
ments, pastries, and fried foods, should be positively avoided in 
the case of all children under five and six years of age. 

The diet from now on will be considered in the chapter 
" Diet and Nutrition." 



PART III 
THE CHILD 



PART III 
THE CHILD 



CHAPTER XXV 
THE SICK CHILD 

TO the mother who has passed through the experience of 
bringing the child into the world is usually given that 
intuitiveness which helps her in caring for that child when it 
is well and in recognizing certain symptoms when it is sick. 
The newborn baby brings with him a large responsibility, but 
as the weeks pass by his care becomes less and less of a nervous 
strain, as the routine duties, so nearly alike each day of his 
little life, have made the task comparatively easy; but when the 
baby gets sick, particularly if he is under one year of age, and 
it is impossible for him clearly to make known his wants, and 
being unable to tell where it hurts or how badly it hurts, the 
average mother is likely to become somewhat panicky; and 
this confusion of mind often renders her quite unfit success- 
fully to nurse the sick baby. 

THE NURSE 

It is often wise to secure the services of a trained nurse, 
and if the family purse will allow such services, a good, sin- 
cere, capable, practical nurse should be engaged, for her firm 
kindness will often accomplish much more than the uninten- 
tional irritability and anxious solicitude of an overworked and 
nervous mother. 

Usually the mother not only attempts the care of the sick 
baby with the long night vigil — often not having the oppor- 
tunity to take a bath or change her raiment day in and day 
out — but she often attempts to manage the entire household 

251 



2$2 THE MOTHER AND HER CHILD 

as well, including the getting of the meals and' keeping the 
house cleaned, and it is not to be wondered at that her nerves 
become overtaxed and in an unlooked for moment she becomes 
irritable and cross with the sick child. 

No matter how low the financial conditions of the family may- 
be, outside help is always essential in cases of severe or long- 
continued illness of the children. Should the mother insist 
upon caring for the baby herself, then all household duties 
should be given over to outside help, and as she takes the role 
of the nurse, the same daily outing and sleep that an outside 
nurse would receive should be hers to enjoy. 

Dr. Griffith has so ably detailed the " features of disease " 
that we can do no better than to quote the following : * 



The position assumed in sickness is a matter of importance. A 
child feverish or in pain is usually very restless even when asleep. 
When awake it desires constantly to be taken up, put down again, 
or carried about. Sometimes, however, at the beginning of an acute 
disease it lies heavy and stupid for a long time. In prolonged ill- 
nesses and in severe acute disorders the great exhaustion is shown 
by the child lying upon its back, with its face turned toward the 
ceiling, in a condition of complete apathy. It may remain like a log, 
scarcely breathing for days before death takes place. Perfect immo- 
bility may also be seen in children who are entirely unconscious 
although not exhausted. 

A constant tossing off of the covers at night occurs early in 
rickets, but, of course, is seen in many healthy infants, especially if 
they are too warmly covered. A baby shows a desire to be propped 
up with pillows or to sit erect or to be carried in the mother's arms 
with its head over her shoulder whenever breathing is much inter- 
fered with, as in diphtheria of the larynx and in affections of the 
heart and lungs. The constant assumption of one position or the 
keeping of one part of the body still, may indicate paralysis. When, 
however, a cry attends a forcible change of position, it shows that 
the child was still because movement caused pain. 

Sleeping with the mouth open and the head thrown back often 
attends chronic enlargement of the tonsils and the presence of 



* From Griffith's Care of the Baby, copyrighted by W. B. Saunders 
Company. 



THE SICK CHILD 253 

adenoid growths in young children, although it may be seen in other 
affections which make breathing difficult. In inflammation of the 
brain the head is often drawn far back and held stiffly so. Some- 
times, too, in this disease the child lies upon one side with the back 
arched, the knees drawn up, and the arms crossed over the chest. 
A constant burying of the face in the pillow or in the mother's 
lap occurs in severe inflammation of the eyes. 

GESTURES 

The gestures are often indicative of disease. Babies frequently 
place the hands near the seat of pain ; thus in slight inflammation 
of the mouth they tend to put the hand in the mouth ; in earache 
to move it to the ear; and in headache to raise it to the head. 
In headache or in affections of the brain they sometimes pluck at 
the hair or the ears, although they may often do this when there 
is no such trouble. Picking at the nose or at the opening 
of the bowel is seen in irritation of the intestine from worms or 
oftener from other cause. A child with a painful disease of its 
chest may sometimes place its hand on its abdomen, or a hungry 
child try to put its fists into its mouth. 

In approaching convulsions the thumbs are often drawn tightly 
into the palms of the hands and the toes are stiffly bent or straight- 
ened. Very young babies, however, tend to do this, although 
healthy. The alternate doubling up and straightening of the body, 
with squirming movements, making of fists, kicking, and crying, 
are indications of colic. This is especially true if the symptoms 
come on suddenly and disappear as suddenly, perhaps attended 
by the expulsion of gas from the bowel. 

SKIN COLOR 

The color of the skin is often altered in disease. It is yellow in 
jaundice, and is bluish, especially over the face, in congenital heart 
disease. There is a purplish tint around the eyes and mouth, with 
a prominence of the veins of the face, in weakly children or in those 
with disordered digestion. A pale circle around the mouth accom- 
panies nausea. The skin frequently acquires an earthy hue in 
chronic diarrhea, and is pale in any condition in which the blood 
is impoverished, as in Bright's disease, rickets, consumption, or 
any exhausted state. Flushing of the face accompanies fever, but 
besides this there is often seen a flushing without fever in older 
children the subjects of chronic disorders of digestion. Sudden 
flushing or paling is sometimes seen in disease of the brain. 



254 THE MOTHER AND HER CHILD 

FACIAL EXPRESSION 

The expression of the face varies with the disease. In whooping 
cough and measles the face is swollen and somewhat flushed, giving 
the child a heavy, stupid expression. There is also swelling of the 
face, especially about the eyes, in Bright's disease. Repeated mo- 
mentary crossing of the eyes often indicates approaching convul- 
sions. In very severe acute diarrhea it is astonishing with what 
rapidity the face will become sunken and shriveled, and so covered 
with deep lines that the baby is almost unrecognizable. The same 
thing occurs more slowly in the condition commonly known as 
marasmus. Often the face has an expression of distress in the 
beginning of any serious disease. If the edges of the nostrils move 
in and out with breathing, we may suspect some difficulty of res- 
piration, such as attends pneumonia. The baby sleeps with its eyes 
half open in exhausted conditions or when suffering pain. 

THE HEAD 

The head exhibits certain noteworthy features. Excessive per- 
spiration when sleeping is an early symptom of rickets. It must be 
remembered, however, that any debilitated child may perspire more 
or less when asleep. Both in rickets and in hydrocephalus (water 
on the brain) the face seems small and the head large, but in the 
former the head is square and flat on top, while in the latter it is 
of a somewhat globular shape. The fontanelle is prominent and 
throbs forcibly in inflammation of the brain, is too large in rickets 
and hydrocephalus, bulges in the latter affection, and sometimes 
sinks in conditions with only slight debility. 

THE CHEST 

The chest exhibits a heaving movement with a drawing in of the 
spaces between the ribs in any disease in which breathing is diffi- 
cult. A chicken-breasted chest is seen in Pott's disease of the spine, 
and to some extent in bad cases of enlargement of the tonsillar 
tissue ; a " violin-shaped " chest in rickets ; a bulging of one side in 
pleurisy with fluid; and a long, narrow chest, with a general flat- 
tening of the upper part, in older children predisposed to con- 
sumption. 

THE ABDOMEN 

The abdomen is swollen and hard in colic. It is also much dis- 
tended with gas in rickets, and is constantly so in chronic indiges- 



THE SICK CHILD 255 

tion in later childhood. It is usually much sunken in inflammation 
of the brain or in severe exhausting diarrhea or marasmus. It 
may be distended with liquid in some cases of dropsy. 

THE CRY 

The study of the cry furnishes one of the most valuable means 
of learning what ails a baby. A persistent cry may be produced by 
the intense, constant itching of eczema. 

The paroxysmal cry, very severe for a time and then ceasing abso- 
lutely, is probably due to colic, particularly if accompanied by the 
distention of the abdomen and the movements of the body already 
referred to. A frequent, peevish, whining cry is heard in children 
with general poor health or discomfort. A single shrill scream 
uttered now and then is often heard in inflammation of the brain. 
In any disease in which there is difficulty in getting enough air into 
the lungs, as in pneumonia, the cry is usually very short and the 
child cries but little, because it cannot hold its breath long enough 
for it. A nasal cry occurs with cold in the head. 

A short cry immediately after coughing indicates that the cough 
hurts the chest. Crying when the bowels are moved shows that 
there is pain at that time. A child of from two to six years, waking 
at night with violent screaming, is probably suffering from night 
terrors. In conditions of very great weakness and exhaustion the 
baby moans feebly, or it may twist its face into the position for 
crying, but emit no sound at all. This latter is also true in some 
cases of inflammation of the larynx, while in other cases the cry 
is hoarse or croupy. Crying when anything goes into the mouth 
makes one suspect some trouble there. If it occurs with swallow- 
ing, it is probable that the throat is inflamed. 

With the act of crying there ought always to be tears in children 
over three or four months of age. If there are none, serious disease 
is indicated, and their reappearance is then a good sign. 

COUGHING 

The character of the cough is also instructive. A frequent, loud, 
nearly painless cough, at first tight and later loose, is heard in bron- 
chitis. A short, tight, suppressed cough, which is followed by a 
grimace, and, perhaps, by a cry, indicates some inflammation about 
the chest, often pneumonia. There is a brazen, barking, " croupy " 
cough in spasmodic croup. In inflammation of the larynx, includ- 
ing true croup, the cough may be hoarse, croupy, or sometimes 
almost noiseless. 



256 THE MOTHER AND HER CHILD 

The cough of whooping cough is so peculiar that it must be de- 
scribed separately when considering this disease. Then there are 
certain coughs which are purely nervous or dependent upon remote 
affections. Thus the so-called " stomach cough " is caused by some 
irritation of the stomach or bowels. It is not nearly so frequent as 
mothers suppose. Irritation about the nose or the canal of the 
ears sometimes induces a cough in a similar way. Enlarged tonsils 
or elongated palate or throat irritation may also produce a cough. 

THE BREATHING 

The breathing of a young child, particularly if under one year 
of age and awake, is always slightly irregular. If it becomes very 
decidedly so, we suspect disease, particularly of the brain. A com- 
bination of long pauses, lasting half a minute or a minute, with 
breathing which is at first very faint, gradually becomes more and 
more deep, and then slowly dies away entirely, goes by the name of 
" Cheyne-Stokes respiration," and is found in affections of the brain. 
It is one of the worst of symptoms except in infancy, and even then 
it is very serious. 

The rate of respiration is increased in fever in proportion to the 
height of the temperature. It is increased also by pain in rickets, 
and especially in some affections of the lungs. Sixty respirations a 
minute are not at all excessive for a child of two years with pneu- 
monia, and the speed is frequently decidedly greater than this. 

Breathing is often very slow in disease of the brain, particularly 
tubercular meningitis. Poisoning by opiates produces the same 
effect. Frequent deep sighing or yawning occurs in affections of the 
brain, in faintness, or in great exhaustion, and may be a very un- 
favorable symptom. Breathing entirely through the mouth shows 
that the nose is completely blocked, while snuffling breathing is the 
result of a partial catarrhal obstruction. A gurgling in the throat 
not accompanied by cough may indicate that there is mucus in the 
back part of it, the result of an inflammation, sometimes slight, 
sometimes serious. 

" Labored " breathing, in which the chest is pulled up with each 
breath while the muscles of the neck become tense, the pit of the 
stomach and the spaces between the ribs sink in, and the edges of 
the nostrils move in and out, is seen in conditions where the natural 
ease of respiration is greatly interfered with, as in pneumonia, 
diphtheria of the larynx, asthma, and the like. Long-drawn, noisy 
inspirations and expirations are heard in obstruction of the larynx, 
as from laryngeal diphtheria or spasmodic croup. 



THE SICK CHILD 257 

THE PULSE 

The rate of the pulse is subject to such variations in infants that 
its examination is of less value than it would otherwise be. In 
early childhood its observation is of more service, although even 
then deceptive. Slight irregularity is not uncommon. Unusual 
irregularity is an important symptom in affections of the brain or 
heart. Fever produces an increase in the pulse rate, the degree of 
which depends, as a rule, upon the height of the temperature. Slow- 
ing of the pulse is a very significant symptom, seen particularly in 
affections of the brain, and sometimes in Bright's disease and jaun- 
dice. 

THE TEMPERATURE 

The temperature is of all things important to remember in infancy 
and childhood because fever is easily produced and runs high from 
slight causes. 

Even slight cold or the presence of constipation or slight dis- 
turbances of digestion may in babies sometimes produce a 
temperature of 103 F. or more. We do not speak of fever unless 
the elevation reaches 100 F. A temperature of 102 or 103 F. con- 
stitutes moderate fever, while that of 104 or 105 F. is high fever, 
and above 105 F. very high. A temperature of 107 F. is very dan- 
gerous, and is usually not recovered from. The danger from fever 
depends not only upon its height, but upon its duration also. An 
elevation of 105 F. may be easily borne for a short time, but it 
becomes alarming if much prolonged. 

THE MOUTH 

The tongue of newborn infants is generally whitish and continues 
to be so until the saliva becomes plentiful. After this we usually find 
it coated in disturbances of the stomach and bowels and in nearly 
any disorder accompanied by fever. In scarlet fever the tongue 
becomes bright red after a few days, and in measles and whooping 
cough it is often faintly bluish. In the latter affection an ulcer may 
sometimes be found directly under the tongue, where the thin mem- 
brane binds it to the floor of the mouth. In thrush the tongue is 
covered with white patches like curdled milk. A pale, flabby tongue, 
marked by the teeth at its edges, indicates debility or impaired diges- 
tion. In prolonged or very high fever the tongue grows dry, and 
in some diseases of the stomach or bowels it may look like raw 
beef, 



258 THE MOTHER AND HER CHILD 

Grinding of the teeth is a frequent symptom in infants in whom 
dentition has commenced. It generally indicates an irritated nervous 
system. Most often this depends upon some disturbance of diges- 
tion ; less often upon the presence of worms. The symptom is pres- 
ent during or preceding a convulsion, and may occur, too, in dis- 
ease of the brain. In some babies it appears to be only a nervous 
habit. 

NURSING 

The manner of nursing or swallowing frequently affords impor- 
tant information. A baby whose nose is much obstructed or who 
has pneumonia can nurse but for a moment, and then has to let the 
nipple go in order to breathe more satisfactorily. If it gives a few 
sucks and then drops the nipple with a cry, we must suspect that the 
mouth is sore and that nursing is painful. If it swallows with a 
gurgling noise, often stops to cough, and does as little nursing as 
possible, we suspect that the throat may be sore. The ceasing to 
nurse at all, in the case of a very sick baby, is an evidence of great 
weakness or increasing stupor, and is a most unfavorable symptom. 

THE URINE 

Urine that is high-colored and stains the diaper, or that shows a 
thick, reddish cloud after standing, may accompany fever or indiges- 
tion. Sometimes the urine under these conditions is milky when 
first passed. In some babies a diet containing beef juice or other 
highly nitrogenous food will produce the reddish cloud, or even 
actual, red, sandlike particles. A decidedly yellow stain on the 
diaper occurs when there is jaundice. A faint reddish stain seldom 
indicates blood. The amount of urine passed is scanty in fever, in 
diarrhea, and especially in acute Bright's disease. In the latter dis- 
ease the urine is often of a smoky or even a muddy appearance. 
The possibility of the occurrence of this symptom after scarlet fever 
must always be kept in mind, in order that a physician may be sum- 
moned very quickly, since it is a serious matter. 

THE STOOLS 

We find that the passages are often putty-colored in disorders of 
the liver, frequently bloody or tarry in appearance in bleeding within 
the bowel, and liable to be black after taking bismuth, charcoal, or 
iron, and red after krameria, kino, or haematoxylon. Infants who 
are receiving more milk than they can digest constantly have whit- 
ish lumps in their stools, or even entirely formed but almost white 



THE SICK CHILD 559 

passages. The presence of a certain amount of greenish coloration 
of the passages is not infrequent. This is usually an evidence of 
indigestion, but passages which are yellow when passed and turn to 
a faint pea green some time later are not an indication of disease. 

WHEN BABY GETS SICK 

When baby shows that he is sick, take his temperature as 
directed elsewhere, cut down the feeding to at least one half, 
or, if his temperature is around 102 F. give him nothing but 
rice water or barley water. If he is constipated give him a 
cleansing enema, and if hot and feverish a sponge bath may 
be administered. He should then be put into a bed with light 
covers and wait further orders which the doctor will give on 
his arrival. Give the baby no medicine unless ordered to do 
so by the physician. 

Known to every physician who undertakes the care of chil- 
dren, is the failure of many well-meaning mothers to call him 
early. The mother attempts the care of the baby herself, and 
not until the condition gets beyond her knowledge and wisdom 
does she seek medical advice. In the early hours of an ap- 
proaching cold, the beginning of intestinal indigestion, or at 
the beginning of bronchitis, if the physician can see the child 
early, prolonged illness may be avoided as well as unnecessary 
expense and many heart-breaking experiences. 

FEEDING THE SICK BABY 

Feeding the sick baby differs somewhat with the character 
of the individual disease, but in the outset of any and all dis- 
eases the intestinal tract should not be overburdened with 
food. At the approach of any illness, the food should at least 
be cut down one half; for instance, in the case of a serious 
acute illness accompanied by fever, not only should the strength 
of the food be reduced one half, but water should be given 
plentifully between feedings. It is better never to urge the 
baby to eat at such times — for the ability to digest food is 
very much reduced. 

In cases of acute attacks with much vomiting and fever, 
all milk should be immediately stopped and rice water or bar- 



26o THE MOTHER AND HER CHILD 

ley water substituted. When vomiting ceases and the fever 
approaches normal and food is desired, begin with boiled skim 
milk in small amounts, well diluted with cereal water, and do 
not approach the normal amount of milk for twenty-four to 
forty-eight hours. In this way the weak digestive organs are 
not overtaxed and they gradually resume their usual work of 
good digestion. When a baby seems to have no appetite for 
food, lengthen the intervals from three to four or five hours, 
for feeding when food is not desired usually aggravates disease 
disturbances. 

EXAMINING SICK CHILDREN 

And now, above all times, the early seed sowing of teaching 
the child self-control, teaching him to gargle if he is suffi- 
ciently old enough, to open his mouth and allow observation 
without resistance, brings sure results. The great harm of 
making the doctor and his medicine a threat to obtain obedi- 
ence also brings its harvest at this time; for the doctor, of all 
people, ought to be regarded as the child's best friend. When 
baby is sick, the doctor is needed, his daily visits must not 
be resisted, his medicines must not be feared — these and such 
other matters should be made a part of every child's early 
education. 

Under no circumstances or conditions should we directly 
falsify to a child. Nothing is accomplished by telling a 
child it will not hurt when you know that it will hurt, or that 
the medicine tastes good when you know it is bad-tasting. 
Every physician can recall unnecessary disturbances in the 
office because a mother has allowed a child to acquire a wrong 
mental attitude toward the family physician. 

One mother told her little girl in my office when I wished to 
make an examination for adenoids which necessitated my put- 
ting my finger back of the child's uvula, " Now Mary, the doctor 
won't hurt you at all, it will feel nice." I turned to the little 
girl and said : " Mary, it will not feel nice, it really won't hurt 
you, but it will feel uncomfortable." It was a grave mistake 
to tell her that it would feel nice. The child resisted, and, 
while the examination was successfully made, the greatest of 



THE SICK CHILD 261 

tact had to be used in securing the friendship of the child after 
the examination. 

It is far better when the throat is to be examined to wrap 
the child in a shawl or a sheet with his arms placed at his 
side, and for a member of the family to take him in her lap 
and hold him securely while the physician quickly makes the 
observation. And while we appreciate that sickness is not the 
time to introduce new methods of training, in instances where 
children have been spoiled, it is far better quietly and firmly 
to go about the task in a manner that you know can be car- 
ried through to a successful finish. 

TREATMENT OF SICK CHILDREN 

A sick child should be encouraged to lie in his bed much of 
the time, and the bed should be kept clean and cool. He should 
never be set up suddenly or laid back quickly. In the case of 
a broken leg, all rapid movements should be avoided. A sim- 
ple story or a soothing lullaby, or the giving of a toy, will 
often divert attention when some painful movement must be 
made or some disagreeable task performed. 

Both cleanliness of the body and cleanliness of the mouth 
are exceedingly necessary in sickness. In all instances of dis- 
ease or indisposition, the mouth must receive daily care, for 
stomatitis or gangrene of the mouth often follows neglect. A 
listerine wash in proportion of one to four, or a magnesia 
wash, or the addition of a few drops of essence of cinnamon 
to the mouth wash will do much to prevent such conditions, 
as well as to relieve them. 

Applications of medicine to the throat may be made without 
resistance if the tactful nurse watches her time. She should 
slowly introduce the tongue depressor which may be a flat 
stick or a spoon, when the application of medicine with a 
camel's-hair brush is quickly made to the rolled-out throat as the 
child gags, and if the nurse then quickly diverts his attention 
to some beautiful story or a picture or a new toy, the treat- 
ment is soon forgotten. Under no circumstances argue with or 
scold a sick child. Get everything ready, if possible behind his 
back or in another room, and then with plenty of help make the 



262 THE MOTHER AND HER CHILD 

application or the observation without words, always with 
gentleness and firmness. 

NURSING RECORDS 

Whether the nurse be the mother, caretaker, practical or 
professional nurse, a record should always be kept of the con- 
dition of the patient. The temperature should be reported at 
different periods designated by the physician. The pulse should 
be recorded, the amount of urine passed and the time it was 
passed, the number of bowel movements, all feedings and the 
general well being of the child — whether it is restless or com- 
fortable, sleeping or awake, together with the water that he 
drinks. 

The record may be kept, if necessary, on a piece of common 
letter paper, and should read something like this: 

March 26, 1916 
7 a. m. Temperature 102; pulse 132; respiration 40; morn- 
ing toilet; took 4 ounces of milk; 2 ounces of barley water; 

1 ounce of lime water. 

9 A. m. Enema given ; good bowel movement ; mustard paste 
applied to chest, front and back, and oil-silk jacket applied; 
drank boiled water, 4 ounces. 

n a. m. Took the juice of one orange; temperature 103; pulse 

135. 
12 Noon. Very listless and nervous; temperature 104. Has 

coughed a great deal. Gave mustard paste to chest, front 

and back, and wet-sheet pack. 
1:30 p. m. Temperature 101.8; 4 ounces of water to drink; 

looks better. 
3 p. m. Has slept \y 2 hours; temperature 102.5; pulse 134; 

respiration 40; 6 ounces of food given (3 ounces of milk, 

2 ounces of barley water and 1 ounce of lime water). 

A record like this is a great help to the physician, and such 
a record may be kept by anyone who can read and write. 
There are printed record blanks which may be procured from 
any medical supply house and most drug stores. 



THE SICK CHILD 263 

BAD-TASTING MEDICINES 

Castor oil has neither a pleasant smell nor taste, and noth- 
ing is accomplished by telling the child that it does smell good 
or taste good. If the patient is old enough to drink from a 
cup, put in a layer of orange juice and then the castor oil and 
then another layer of orange juice, and in this way it often 
can be easily taken. Someone has suggested that a piece of ice 
held in the mouth just before the medicine is taken will often 
make a bad dose go down without so much forcing. A taste 
of currant jelly, or a bit of sweet chocolate, or the chewing 
of a stick of cinnamon is a great adjunct to the administra- 
tion of bad-tasting medicines. All oily medicines must be 
kept in a cool place and should always be given in spoons or 
from medicine glasses that have first been dipped in very cold 
water. Very often the addition of sugar to bad-tasting medi- 
cines will in no wise interfere with their action, while it often 
facilitates the administration of the disagreeable dose. The 
majority of bad-tasting medicines are now put up in the form 
of chocolate-flavored candy tablets. 

TEMPERATURES AND PULSE 

The normal temperature of a baby is 98.5 to 99 F. in the 
rectum. After shaking the mercury of the thermometer down 
below the 97 mark it is well lubricated with vaseline and then 
carefully, gently, pushed into the rectum for about an inch and 
a half or two inches, and left there for three minutes before 
removing. 

Mothers should exercise self-control in taking the tempera- 
ture, for nothing is gained by allowing a panicky fear to seize 
you should the mercury register higher than you anticipated. 
Notify your physician when the temperature registers above 
100 F. 

The respirations of a child are fairly regular and rhythmic 
and occur about forty times per minute during the first month 
of life and about thirty times per minute during the remainder 
of the year. From one to two years, twenty-six to twenty- 
eight is the average. Breathing is somewhat irregular when 



264 THE MOTHER AND HER CHILD 

the child is awake and may be a bit slower when asleep. Before 
the baby is born the fetal pulse is about 150. At birth it ranges 
from 130 to 140. During the first month the pulse is found 
to be from 120 to 140. By the sixth month it gets down to 
120 or 130, and from that on to a year the normal pulse beat 
of the baby is about 120. The pulse is influenced very much by 
exercise and is often increased by crying or nursing or any 
other excitement. 

FEVER 

Children get fever very easily — the digestive disturbance of 
overeating, constipation, a slight bilious attack — all produce 
fever which disappears quite as suddenly as it came. The first 
thing to do under such circumstances is to withhold food, give 
plenty of water to drink, produce a brisk movement of the 
bowel by giving a dose of castor oil, give a cleansing enema, 
and treat the fever as follows: 

After removing all of the clothes from the child, place him 
in a warm blanket and then prepare a sponge bath which 
may be equal parts of alcohol and water; expose one portion 
of the body at a time and apply the water and alcohol first to 
one arm and then to the other arm, the chest, one leg, the 
other leg, the back and then the buttocks. Do not dry the part 
but allow evaporation to take place, and this, accompanied by 
the cooling of the blood which is brought to the skin by the 
friction, readily reduces the fever. Another procedure which 
may be employed if the fever registers high is the wet-sheet 
pack which is administered as follows: 

Three thicknesses of wool blankets are placed on the bed 
and a sheet as long as the baby and just enough to wrap 
around him once, is wrung out of cool water and spread over 
these blankets. With a hot-water bottle to the feet, the child 
is then laid down in the wet sheet which is now brought in 
contact with every portion of his body, then the blankets are 
quickly brought around, and he is allowed to warm up the 
sheet — which lowers his temperature. 

Another valuable procedure is the cooling enema. Water 
the same temperature as that of the body, is allowed to enter 



THE SICK CHILD 265 

the bowel and is then quickly cooled down to 90 or 85 F. ; in this 
manner much heat is taken out of the body and the fever 
quickly reduced. (For further treatment of fevers see Ap- 
pendix.) 



CHAPTER XXVI 
BABY'S SICK ROOM 

VISITORS should never be allowed in the sick room dur- 
ing the height of a disease, and during convalescence not 
more than one visitor should be allowed at one time, and the 
visit then should be only two or three minutes in length. The 
order and the quietness and the system of the sick room 
should be perfect. Visitors and loitering members of the 
family do no good and they may do much harm to the recuper- 
ating nervous system of the child. 

LOCATION OF THE SICK ROOM 

In these days of high rents, we realize that the greater per 
cent of our readers are living in apartments and homes just 
big enough conveniently to care for the family during health, 
and while it would be pleasant and convenient to have a spare 
room or an attic chamber that could be used in case of illness, 
it is the exception rather than the rule that the families to 
whom sickness comes have these extra apartments. When a 
contagious or an infectious disease comes to the family, it is 
of great importance that the sick child be isolated, preferably 
on another floor, from that used by the immediate family. 

Those living in homes, more than likely can fix up a room 
on the attic floor for the isolation, and those living in apart- 
ments may put the sick child in one end of the apartment, while 
they inhabit the other end. One family under my observation 
not long ago had a child stricken with the measles. In the same 
apartment there lived a puny baby not quite two years old. 
Coming as it did in February, the mother of the child was 
apprehensive, fearing that measles would leave a severe bron- 
chitis which might mean the death of the already too-delicate 

266 



BABY'S SICK ROOM 267 

baby. She was instructed to move the baby's bed to the sun 
parlor in the front of the flat, while the boy with the measles 
was put in the parents' room in the rear end of the flat. A 
sheet was suspended in the middle of the hall leading from the 
living-room to the bedrooms. Door knobs were disinfected 
daily, a caretaker was put in charge of the measles patient, the 
mother very frequently was compelled to go back and adminis- 
ter a treatment, but each time she donned a large apron and 
completely covered her hair with a towel, she administered 
the treatment, took off her wrappings, thoroughly washed 
her face and hands — disinfected them — and returned to her 
baby in the front part of the house. 

At night this mother slept on the floor on springs and mattress 
in the living-room, and to that home the measles came and 
departed, and the baby did not get them at all, so perfect was 
the isolation, so vigilant the disinfection, and so scrupulous the 
care to prevent contamination. So you see from this one 
instance that it is altogether possible to make isolation complete 
even on the same floor. But, mind you, the dishes that the lad 
ate from were all kept in his room. Food was brought to the 
sheet and there the caretaker held her dishes while the cook 
poured or lifted the food from her clean dishes to the dishes 
the caretaker brought from the sick room. 

Whether the sick room is in the attic or whether it be the 
rear end of an apartment, if the principles of contagion and 
disinfection are understood I believe it is perfectly possible 
to isolate even scarlet fever without danger to the other mem- 
bers of the family. 

NECESSARY FURNISHINGS 

For slight indispositions and trifling disorders, it is not neces- 
sary to strip the room of its adornment, but it is well to clear 
off the dresser tops, protect them well with many thicknesses 
of newspapers covered over by a folded sheet so that alcohol, 
witch-hazel and other necessaries will not injure the mahogany 
or oak-top dresser. Whenever the children are sick, rob the 
room of anything that is going to be in your way. In instances 
of infectious or contagious diseases, take down all silk or wool 



268 THE MOTHER AND HER CHILD 

hangings, replace them by washable curtains or inexpensive 
ones that can be burned if necessary, and remove valuable 
paintings and other bric-a-brac that later fumigation will harm 
or that may gather the dust during the days of illness. 

Just as it is necessary for the man who mines the coal to wear 
suitable garments, and for the woman who does the scrubbing 
to dress accordingly, and for the nurse who cares for the case 
to wear washable clothes — so it is necessary to dress the 
sick room in garments that are suitable, convenient, and capa- 
ble of being thoroughly disinfected, fumigated, or even burned 
if the occasion demands. Hence, expensive rugs should be 
replaced by rag carpets or no rug at all, while unnecessary 
articles and garments should be removed from closets, etc. 

Remembering that the little fellow is to remain in this room 
for possibly two weeks or maybe six weeks, let us put up 
some bright-colored pictures that he will enjoy, bring in some 
books and magazines by which he may be entertained, secure 
a few simple toys that will not tax the brain, but serve as a 
help to pass away the long hours. There are many paper 
games that may be had, such as transfer pictures, picture puz- 
zles, kindergarten papers, drawing pictures, as well as toys that 
may be put together to fashion new articles. A whole lot of 
fun can be gotten out of a bunch of burrs that can be stuck 
together to make men, animals, houses, etc. Scissors and 
pictures are entertaining as well as paper dolls with their ward- 
robes. Rubber balloons, or a target gun for the boy of six 
will be a great source of delight to him; as will a doll with a 
trunk full of clothes for the little girl during her convalescent 
days. A tactful nurse and a resourceful mother will think of 
all the rest that we have not mentioned — which will amuse, 
entertain and keep happy our convalescent children, help them 
to forget that they are " shut ins." 

THE NURSERY REFRIGERATOR 

It is wise in instances of the more severe childhood troubles, 
such as infectious and contagious diseases, to keep as many 
things in the sick room as possible, and so we remind our 
reader of the home-made ice box, described elsewhere in this 



BABY'S SICK ROOM 269 

book, in which may be kept the fruit juices and the fruits, as 
well as the milk and the buttermilk. Many medicines, particu- 
larly the oily medicines, should be kept in this home-made ice 
box and five cents worth of ice a day will not only make things 
taste better, especially during the warm months, but will pro- 
tect the other members of the family, for the family ice box 
is a big central station which must be protected against infec- 
tions and carriers of disease. 

In connection with the ice box, we are reminded that it 
would be a great convenience to have a simple contrivance 
for heating bouillon, milk, or making a piece of toast, which 
can be readily done with an electric heater, an alcohol stove, 
or a small apparatus fitting over the gas jet. 

SICK ROOM DISINFECTANTS 

The most important thing which we are going to mention 
in this division of the chapter is the disinfection of the door 
knobs. According to the directions on the poison bottle, place 
an antiseptic tablet into a small amount of water which will 
make a solution of 1 to 1000 of bichlorid of mercury, and sev- 
eral times a day disinfect the door knobs, particularly in the 
sick end of the house — thoroughly washing and adequately 
rubbing with a towel moistened in this solution. 

All stools and urine from the sick one will receive atten- 
tion as directed by the physician. The stools from a typhoid 
patient should stand for one-half hour in a chamber covered 
with a layer of lime. 

It is not at all necessary to have vessels containing disinfect- 
ant substances standing about the room and in the closet. In 
a room adjoining should be kept all of the dishes used by the 
sick patient, his tray, half a dozen napkins, knife, fork, spoon, 
serving dishes, drinking glass, pitcher, etc. All bedding and 
all linen used by the sick member should be allowed to stand 
in a solution of disinfectant for several hours when they may 
be wrung out of the solution, dropped into a bucket and car- 
ried to the laundry without any danger to other members of the 
family. 

The nurse is not allowed to leave this room in the garments 



2-o THE MOTHER AXD HER CHILD 

that are worn while caring for the sick. She should have her 
meals in an adjoining room which is also under strict isolation. 

THE MEDICINE CHEST 

The sick room medicine chest should be so placed on the 
wall that it is outside the reach of the smaller members of the 
family, for in it should be placed poisons for external use that 
are capable of producing death if taken internally. Bottles 
that hold these poisons — such as bichlorid of mercury, lysol, 
carbolic acid, laudanum, paregoric., belladonna, etc. — should 
be so different from the other bottles in the medicine chest 
that if one should reach for them with his eyes shut or in the 
dark he would at once recognize that he had hold of a poison 
bottle> This is absolutely necessary. It usually means a bit 
of extra expense, but when we realize what tragedies may be 
avoided by such slight expense, it must not be considered. 

Bottles may be procured that have been molded with points 
of glass projecting from the outside which make them rough to 
the touch, or they may be covered with a wire mesh or with a 
wicker covering which may easily be told from the other bot- 
tles in the case. 

One woman lost her life because the nurse placed two ounces 
of carbolic acid in the enema instead of two ounces of saline 
solution. Saline solution is nothing but salt and water, while 
carbolic acid cost the woman her life, simply because the car- 
bolic acid was not placed in a specialized poison bottle and the 
attendant could not read the label in the dark. 

Under no circumstances keep from one year to another the 
remnants of unused medicine of a former sickness, for medi- 
cines do not keep well and often lose their strength if kept 
longer than the physician intended. 

In this medicine chest should be found the following articles : 

A glass graduate marked with fluid drachms (i teaspoon), 
and fluid ounces (8 teaspoons). 
A medicine dropper. 

Absorbent cotton. 
Boric acid. 



BABY'S SICK ROOM 271 

Camphorated oil. 
Castor oil. 

Aromatic spirits of ammonia. 
Alcohol. 
Olive oil. 
Epsom salts. 
Soda-mint tablets. 
Vaseline. 

Zinc ointment, together with other medicines the physician 
orders. 
Ice bag, hot-water bottle and oiled silk. 

Besides these articles, in the nursery — in readiness for emer- 
gencies and accidents — should be found the following : 

Gauze bandages of various sizes. 
Sterile gauze. 

Boric acid crystals and powder. 
Mustard. 

A pocket case of instruments containing scissors, knife, dress- 
ing forceps, etc. 
Syrup of ipecac. 
Glycerin. 

Tincture of iodine. 
Package of ordinary baking soda. 
Peroxid of hydrogen. 
Absorbent cotton. 
Needle and thread. 
Lime water. 

PATENT MEDICINES 

Aside from the giving of castor oil and the application of 
vaseline to the nose, or of applying boracic acid to the eyes, 
no medicine should be administered to the baby without com- 
petent medical advice. There are numerous widely advertised 
nostrums frequently sold as soothing syrups to be used during 
the teething or during attacks of diarrhea, or cough spasms, 
croup, or worms, that contain dangerous drugs and should not 



272 THE MOTHER AND HER CHILD 

be given to children. Many well-meaning but ignorant moth- 
ers are slowly but surely laying the foundations for serious 
nervous disorders and are often making veritable dope fiends 
out of their children. Patent medicines are dangerous things 
in the hands of the people; if we are going to give medicines 
to our little babies let us at least know what we are giving. 
Let some conscientious, scientific physician examine the baby 
and prescribe for its needs. 

If urged to use a patent medicine, examine the label care- 
fully, for the Federal Food and Drug Act requires the manufac- 
turer of patent medicines to print plainly on the label of the 
bottle the name and amount of certain dangerous drugs which 
it may contain. 

The drugs mentioned in this drug act and which are often 
used in patent medicine nostrums are, chloral hydrate, cocaine, 
heroin, chloroform, alpha or beta eucaine, opium, morphin, 
alcohol, cannabis indica, or any derivative or preparation of 
any such substance contained therein. 

There are many other drugs sold on the market containing 
syrups or flavoring materials which may do harm — which may 
upset the baby's digestion. 

Mothers avoid patent medicines. Consult your physician. 
Never give a baby any sort of medicine to induce sleep. Unless 
babies are sick or spoiled or hungry, they will go to sleep of 
themselves, and even in the days of a high fever a wet-sheet 
pack seldom ever fails to put the baby to sleep and can do no 
harm if properly given. 

This may be as good a place as any to mention the dosage 
of castor oil which is as follows: 

Up to three months, y 2 teaspoon. 

From three to six months, I teaspoon. 

From six to nine months, 1^2 teaspoons. 

From nine to twelve months, 1 dessert spoon (2 teaspoons). 

From twelve months on, 1 to 2 tablespoons. 

AFTER THE SICKNESS IS OVER 

The physician will direct when the disinfectant bath is to be 
given to the patient previous to his liberation from isolation. 



BABY'S SICK ROOM 273 

The different diseases demand different treatment, but, on the 
whole, it is about as follows: 

The day before the boy is to be allowed to go out among 
the family once more he receives a soap wash, clean sheet and 
bedding on the bed, and puts on clean garments. The following 
morning, his head thoroughly shampooed, his nails manicured, 
a second soap wash is given followed by a weak bichlorid bath 
(1 to 10,000 solution) which is followed by an alcohol rub. He 
is then allowed to go out of the sick room which is now to be 
thoroughly disinfected and fumigated. 

After the illness is over, the sick room and the adjoining 
closets and ante rooms must be thoroughly disinfected or fumi- 
gated. If you are located in a city, the health authorities will 
do this after an infectious or contagious disease. Away from 
such conveniences, use the following method : 

Place two ounces of crystals of permanganate of potash in a 
pan and have a pint bottle of formalin near by. Everything 
in the room is now exposed, dresser drawers are opened, all 
bedding, all garments — in fact everything that is in the room 
— is put in such a position as to be readily exposed to the 
fumes which are to follow. A line should be stretched across 
the room over which are thrown the bedding, garments, etc. The 
cracks of the windows and doors, except the one door of exit, 
are now sealed up with paper which has been dipped in green 
soap, and having the paper strips and pan of green soap ready 
just outside the exit door, the formalin is now poured over the 
permanganate crystals. Fumes will immediately arise and per- 
meate every corner, crack and crevice of the sick room. Now 
quickly make your exit, close the door and seal up key hole 
and cracks and space under the door with paper dipped in 
green soap. Leave the room for six hours. After this with 
a well-moistened cloth to the nose, rush in and throw the win- 
dows open, hurry out and allow the room to air from twelve to 
twenty-four hours, after which wash woodwork and painted 
walls or take paper off and repaper walls ; recalcimine ceilings 
and closets ; scrub closet shelves and dresser drawers, bedsteads, 
and other furniture thoroughly. If the mattress is old throw it 
away, but if not, sun it for several days following the fumigation. 



CHAPTER XXVII 
DIGESTIVE DISORDERS 

IN this chapter we will consider the diseases which commonly 
occur during infancy and early childhood relative to diges- 
tion and the alimentary tract. Irregularity of feeding, feed- 
ing between meals, feeding too much at any given time, as well 
as feeding the wrong kind of food may cause stomach disturb- 
ances and intestinal troubles. 

VOMITING 

In a previous chapter, " The Feeding Problem," a common 
stomach disturbance, vomiting, was gone into quite thoroughly, 
and in passing to other disorders, we wish to remind the mother 
that vomiting should always be taken seriously. The interval 
between meals should usually be lengthened, the time spent in 
feeding shortened, and it is often necessary to withhold all milk 
and food of any kind for twelve or eighteen hours, giving only 
boiled, unsweetened water. Vomiting frequently ushers in some 
acute disease, and in remote cases, when it is very persistent, 
it may indicate inflammation of the brain. Complete rest is 
essential, trotting on the knee, suddenly changing the baby's 
position, or other quick movements must all be avoided. A 
physician should see the sick one and determine the cause of the 
trouble. 

COLIC 

Cases of ordinary colic are usually relieved by heat to the 
abdomen and feet, drinking hot water in which there has 
been dissolved a pinch of ordinary baking soda, or a portion 
of a soda mint tablet, or by the use of the photophore, as pre- 
viously described. The treatment of such ordinary colic need 

274 



DIGESTIVE DISORDERS 275 

not be given further consideration here because it has been 
described at length in a former chapter; but we do call the 
attention of the mother to a more serious form of recurring 
colic which so often accompanies chronic intestinal indigestion, 
marasmus, and malnutrition. 

In most instances the food is radically at fault and should 
be reduced to a mixture which can more readily be digested 
and assimilated by the child. Often whey mixtures, pep- 
tonized foods, or buttermilk may be indicated. The weight of 
the baby, the age of the baby, and the color of the stools, 
must all be taken into account in the preparation of this 
easily digested food. Weak mixtures should be given at first 
and then gradually and carefully the quality may be strengthened 
until the normal formula is again used for the baby. 

Injections into the bowel of water, to which has been added 
one level teaspoon of soda to the pint, will often give relief in 
this form of colic. 

CHRONIC INDIGESTION 

While this condition may occur at any time during baby- 
hood days, it often makes its appearance during the last half 
of the first year and up to the fifth year. It is accompanied 
by mucus in the stools, chronic flatulence, constipation or 
diarrhea, or the alternating of the two, restlessness at night, 
distention of the abdomen (" pot bellied ") accompanied by pain, 
a coated tongue with a fetid breath, and loss of appetite. It 
is a pitiable picture — the weight is usually reduced and the 
child gives the appearance of being decidedly undernourished. 
This condition is usually occasioned by errors in diet, whether 
it be over-feeding or feeding of the wrong element of food, 
and, since the diet is usually responsible for the condition, in 
the line of treatment diet is a prime factor. 

All fats must be taken from the food, sugars should be 
avoided, and the amount of starchy foods, such as flour, pota- 
toes and bread, should be greatly reduced. Buttermilk, skimmed 
milk, eggs, green vegetables, and fruit juices should be given. 
In the older child, if grains are used, they should be well 
toasted or baked. 



276 THE MOTHER AND HER CHILD 

JAUNDICE 

It is altogether common and physiological for the newborn 
baby to pass through a few days of yellow skin which usually 
clears up in the second or third week, but it should not recur. 
Occasionally this yellow tint deepens, the whites of the eyes 
are yellow, the urine passed leaves a yellow stain on the diaper, 
while passages from the bowels are white or clay colored. If 
the child shows symptoms of ill health other than the yellow 
tint, it should receive medical attention. Older children troubled 
with jaundice should receive the following treatment: The 
photophore as described elsewhere should be applied to the 
liver and abdomen (the liver is on the right side), and this 
should be followed by the application of what is known as a 
heating compress, consisting of three layers — a cloth wrung 
from cold water, a mackintosh, and then two thicknesses of 
blanket flannel — which are all applied when the skin has been 
made red by the application of heat. (If the photophore is 
unavailable, a hot-water bottle may be applied.) The flannel 
is pinned snugly on the outside as the wet cloth goes next to 
the skin with the mackintosh between. This should remain on 
the abdomen for three or four hours, after which the hot appli- 
cation is again made to the liver and abdomen. The adminis- 
tration of broken doses of calomel is sometimes indicated in 
obstinate cases in connection with these applications of heat 
to the liver. Hot milk or mineral water may be taken with 
dry toast. In a day or two the color should clear up, the stools 
should be normal again, and the treatment may be discon- 
tinued. 

WORMS 

Irritation about the rectum which cannot be otherwise 
explained is usually suggestive of pinworms. These seatworms 
or pinworms are very much like little pieces of cotton thread — 
one-fourth of an inch in length. They grow and thrive in the 
lower part of the large bowel. Simple and effective treatment is 
as follows: 

It is well to bathe the parts about the rectum after each 
bowel movement and often two or three times a day with a 



DIGESTIVE DISORDERS 277 

weak antiseptic solution. Itching may be controlled by the 
application of a disinfectant ointment, or the local applica- 
tions of ice may serve the same purpose. After a thorough 
cleansing of the colon by an injection of lukewarm water con- 
taining a teaspoon of borax to the pint in order to remove 
the mucus, Doctor Holt suggests that after the discharge of 
this borated enema, infusions of quassia are very helpful (See 
Appendix). 

Children suffering from roundworms experience a loss of 
appetite, varying temperature from above normal to subnormal, 
with colicky pains in the abdomen on coming to the table and 
beginning to eat. They are pale and listless, or nervous and 
irritable. 

Roundworms very much resemble earthworms in shape and 
color. While their home is in the small intestines they often 
travel to other parts of the body. They have sometimes 
crawled into the stomach and have been vomited. The only 
definite symptom of worms is to find the eggs or the worms 
themselves in the stool. No worm medicine should ever be 
given by the mouth without being prescribed by a physician. 
Cases are on record where well-meaning mothers have killed 
their children by giving an over dose of worm medicine. 

Tapeworms sometimes trouble children; their segments are 
found in the stool, and look like small pieces of tape line. The 
segments are flat and thin, one-fourth inch to one-half inch in 
width and three-fourths to one inch in length. They are joined 
together and often their number is so great the worm is many 
feet in length. The segments grow smaller and smaller as 
they approach the neck, the head of the worm being a mere 
point. As the worm is passing from the child it should never 
be pulled, as the head is easily broken off, and, on remaining 
in the bowel, it will grow to a full-sized worm. 

Worms come from the eating of half-cooked meats; they 
enter the stomach as eggs or tiny worms, and pass out into the 
small intestines, where they begin to grow. They are a com- 
mon parasite in the human family and should be suspected in 
all instances where digestive symptoms are masked or do not 
yield to treatment. 



278 THE MOTHER AND HER CHILD 

HOOKWORM DISEASE 

This disease, once seen only in the southern part of the 
United States, is leaving its former domains as the migrating 
population is distributing it more or less widely everywhere. 
Sandy soil and country districts are infected by a tiny worm 
which thrives in polluted soil and enters the body through the 
skin of the feet. It also gets into the body through the drinking 
water or from the eating of uncooked vegetables, such as are 
used in salads. 

The disease is manifested by " sallow skin, paleness, head- 
ache, swollen abdomen and sores on the legs." Little swollen 
places where the worm enters the skin may be seen on the 
flesh. The condition yields readily to treatment. If a child 
is discovered scratching his feet (especially in the southern 
part of this country), he should be taken at once to a physician. 

DISORDERED STOMACH 

At the first symptom of a disordered stomach take all food 
from the baby and give him rice water prepared by throwing 
a cupful of well-washed rice into a kettle of boiling water and 
allowing it to continue to boil for a couple of hours. The 
water which is strained off is rice water, ready for use after 
it is cooled. This may be given to the child at the meal hour 
in the place of his regular food. It should be kept in a glass- 
covered jar in the ice box. A dose of castor oil, according to 
the age, should be administered before the feed. The bowels 
should be washed out and boiled water given freely between 
the meals of rice water. For a day or two (twenty-four to 
forty-eight hours), the child should be fed only this rice water, 
or until the temperature returns to normal and he appears very 
hungry, at which time milk, which has been boiled for five 
minutes, may be added to the rice water, first in one-half ounce 
quantities and gradually increased. Each day a little more 
milk is added until baby is taking his regular food again. 

Many a death and many acute attacks of summer complaint 
are avoided by the quick use of castor oil, and by withholding 
food and stopping the use of milk as soon as the child becomes 
ill. 



DIGESTIVE DISORDERS 279 

STOMATITIS OR THRUSH 

Thrush is evidenced by fretfulness or crying on attempting 
to nurse. On examination of the mouth it is found to be hot 
and very tender and covered with little white specks which, 
if looked at under the microscope, appear to be a fungus 
growth. If scratched off, the mucous membrane bleeds easily. 
Thrush often occurs during a fever or in connection with other 
diseases, and is often due to neglect and lack of cleanliness 
about the bottles, nipples, etc. Taken in time it is quickly 
cured. An immediate dose of castor oil or milk of magnesia 
is indicated, and the use of a mouth wash which will be pre- 
scribed by the physician. If neglected, it may become ulcerous 
or gangrenous, which is a very serious condition. Everything 
pertaining to the feeding, as well as the child's toys, hands, 
etc., must be kept scrupulously clean. 

CONSTIPATION 

In the chapter, " The Feeding Problem," constipation in 
bottle-fed babies was discussed. The bowels should move at 
least once in twenty-four hours. The passages are frequently 
very hard and leave the body only after a very great effort of 
straining. This constipation, often continuing until late child- 
hood, should be corrected in the following manner: 

In early infancy — as early as the fourth month — prune 
juice may be given as directed elsewhere, while in later 
months prune pulp or fig pulp, which has been carefully rubbed 
through a fine-mesh colander, may be given at meal time. By 
the time the baby is eleven or twelve months old, strained apple 
sauce may be given. 

We deplore the use of the water enema as a regular daily 
procedure; in its place we suggest the use of the enema of oil 
or the introduction into the rectum of a gluten suppository or 
in obstinate cases a glycerine suppository. Abdominal mas- 
sage should be daily administered. With a well-oiled hand, 
begin on the right abdomen and proceed upward to the lower 
border of the right ribs and across to the left side and down. 
This should be repeated many times at a regular hour each 
day. The mother should select an hour for the bowels to move, 



280 THE MOTHER' AND HER CHILD 

preferably after the forenoon feeding, and if the child is too 
small to sit upon the toilet chair, a gluten suppository may be 
placed into the rectum before the forenoon feed and some time 
during the middle of the day the bowel movement will be 
found in the napkin. 

For the older child, before a certain meal each day, a well- 
vaselined piece of cotton may be inserted in the rectum; this 
often produces a bowel movement immediately after the meal. 
Laxative foods, such as bran, stewed figs, stewed prunes, or a 
raw apple, should be used faithfully — as repeated medication 
never corrects the difficulty, but usually prolongs it. 

To immediately flush out the bowel, a soapsuds enema or a 
plain water enema may be allowed to flow into the lower colon, 
or a glycerine suppository inserted into the rectum will quickly 
bring a bowel movement. These methods are only of tempo- 
rary value; a regular habit should be formed, if possible, to 
bring about a natural, normal bowel movement. When neces- 
sary to resort to drugs — such remedies as cascara sagrada, 
milk of magnesia, or syrup of rhubarb, are satisfactory, as 
well as our old stand-by — castor oil. Regular habits must be 
insisted upon, and if the mother pays attention to regularity 
at stool in early childhood very little trouble will be met later 
on in adolescence and adult life. 

Chronic constipation often produces abnormal conditions 
about the rectum such as fissures, hemorrhoids, or prolapse, 
which may be of serious import. 

DIARRHEA 

Diarrhea is a symptom of an acute illness, or it may be asso- 
ciated with a chronic condition such as chronic intestinal indi- 
gestion, tuberculosis of the bowel, or may occur alternately with 
constipation in colitis. It is the most dangerous of all symp- 
toms that babies develop, and in spite of all the instruction 
given to mothers at the present time, in spite of all the wel- 
fare stations in large cities, and in spite of all the efforts put 
forth by the commissioner of health, with his corps of visiting 
nurses — even yet, more babies die of diarrhea each summer 
than from any other single cause. 



DIGESTIVE DISORDERS 281 

There are usually just two reasons for diarrhea — uncleanli- 
ness and bad milk. During the hot summer days flies multiply 
greatly and all manner of bacteria and germs grow in warm, 
moist, shadowy places, so that usually before the milk leaves 
the dairy farm it is seriously contaminated with disease-produc- 
ing germs. If the milk is not kept at a temperature of 35 or 
40 F. (which is just above the freezing point), these bacteria, 
particularly the manure germ, grow at such a rate that by the 
time the milk gets to the infant it is teeming with bacteria, and 
diarrhea is the sure result. 

Another form of diarrhea is cholera infantum, where the 
stools soon become watery and colorless. The vomiting is 
almost incessant and there is high fever. Fortunately it is a 
rare disease, but when once seen it is never forgotten. One 
beautiful baby weighing nearly thirty pounds was reduced to 
sixteen within forty-eight hours, and when death came he could 
hardly be recognized because of the wasting from this most 
dreaded of infant diseases. 

Another form of diarrhea is seen in an acute inflammatory 
condition of the intestine itself. The stools contain more or 
less mucus and blood. The bowel movements, which are very 
frequent, are accompanied by a great deal of pain and strain- 
ing. This form is often seen in the more severe types of sum- 
mer dysentery. We wish to impress upon the reader's mind 
that these diarrheas may all be avoided if the baby's food is 
clean and free from germs, if the apple or pear is not only 
washed, but thoroughly scrubbed before paring during the 
summer months. If all the bottles, nipples, water, toys, etc., 
are adequately clean, no summer diarrhea, no dysentery, no other 
infection due to dirt, will attack the baby. Of paramount 
importance is the pasteurization of milk during the summer 
months, as mentioned elsewhere. 

TREATMENT OF DIARRHEA 

Simple diarrhea in the older child of two or three years 
is treated as follows: Take away all solid foods. Give a big 
does of castor oil, thoroughly wash out the bowel by warm 
water containing a level teaspoon of salt and a level teaspoon 



282 THE MOTHER AND HER CHILD 

of baking soda to the pint, and put the child to bed in 
a quiet room. Boil all milk for ten minutes and thicken it 
with flour that has been browned in the oven; feed this to 
the child at five-hour intervals. After each bowel movement, 
no matter how often they come, the colon should be washed 
out with the salt and soda enema as before mentioned. 

Bear in mind that the child is losing liquids, and so, after 
the bowels have moved, boiled water should be given by 
mouth, or a cupful of water can often be retained if it is intro- 
duced into the rectum slowly under very low pressure. Twenty- 
four or forty hours should clear up a case of simple diarrhea, 
and on returning to food it should be dry toast and boiled 
milk. For the younger baby, withhold all milk and give barley 
water or rice water for the first twenty-four hours, returning 
to milk very gradually and slowly. 

For the more severe types, such as the dysentery containing 
mucus and blood, everything that has been done for the simple 
diarrhea should be done; the baby should be kept very quiet, 
while castor oil should be promptly administered. Food is 
withheld and the bowels are carefully irrigated after each 
movement with the salt and soda solutions. After the bowels 
have moved from the castor oil, then bismuth subnitrate, which 
has been dissolved in two ounces of water, should be given — 
one or two teaspoons every three hours. This will naturally 
turn the bowel movements dark. 

Under no circumstances should any other medicines be given 
without the physician's knowledge, as it is at such times as 
this that many " would-be friends " advise laudanum, pare- 
goric, and other opiates. The skin must be kept warm, and 
fluids must replace those that have been carried off in the 
many stools. Water may be given by an enema, by water 
drinking, and in such rare cases as cholera infantum, when 
water cannot be retained on the stomach, it often becomes neces- 
sary to inject it under the skin (hypodermoclysis) so that it 
may go at once to the wasted tissues and perhaps save the 
baby's life. 

Give the baby ten days or two weeks to return to normal 
condition, and under no circumstances hurry the feeding of 



DIGESTIVE DISORDERS 283 

milk, as a second attack may occur much more readily than 
the first; may more profoundly overcome the baby and result 
in death. 

RUPTURE 

A protrusion of a loop or portion of intestine through a 
weakened abdominal muscle — which grows larger when baby 
cries and smaller when he is lying down in a relaxed condi- 
tion — is known as rupture or hernia, and is of common occur- 
rence in infancy. It is often seen at the navel and sometimes 
in the groin as early as the second week. 

Hernia is always dangerous and should never be neglected. 
The physician will protect the navel by a special support with 
adhesive plaster which is carefully renewed twice a week, and 
if worn for several months usually entirely corrects the con- 
dition. A comfortable truss made from skeins of white yarn 
will amply protect a groin hernia. The condition should 
always be taken seriously and receive immediate treatment. 

PROLAPSE OF THE BOWEL 

Occasionally, as the result of severe straining in consti- 
pation, the rectum protrudes sometimes one-half inch, and in 
rare instances two or three inches. The placing of a young 
child upon a toilet chair and insisting upon severe straining 
sometimes results in such a protrusion of the rectum. This 
may be avoided by the application of vaseline to the rectum or 
by the use of the gluten or glycerine suppositories which cause 
the hardened masses to make their way out easily. Someone 
has suggested that if the buttocks are supported by a board 
placed over the toilet seat with a two-inch opening so that 
severe straining of the rectal muscles is impossible, the pro- 
lapse of the rectum will not recur. 

The moment the mother observes the slightest protrusion 
of the rectum she should quickly put it back and have the child 
lie down and move the bowel in the diaper. Very severe cases 
require a physician's attention, but if prompt and quick meas- 
ures are taken on the first appearance it may be quickly cor- 
rected and serious consequences be avoided. 



284 THE MOTHER AND HER CHILD 

In this connection we might mention a condition which some- 
times babies are born with — the absence of the rectal opening. 
If the baby's bowels do not move for the first two days, sur- 
gical interference is more than likely necessary. Often the 
external opening alone is missing. Sometimes there is a com- 
plete closure or atresia of the lower part of the colon. 

BLEEDING FROM THE NAVEL 

There should be no hemorrhage from the umbilical stump 
after it has been properly tied, but occasionally a bit of blood 
is found upon the dressing and a second tying of the cord 
stump is necessary. The cord drops off in eight or ten days, 
and the umbilicus that is left may be moist or it may bleed 
slightly; if such is the case, great care should be exercised in 
bathing this ulcer that has been left behind. It simply should be 
touched with alcohol, a bit of boric acid powder applied, and a 
small piece of sterile gauze be placed over it. In the course of 
two or three days it will entirely heal. Care should always be 
exercised in washing the umbilicus. Extensive hemorrhage 
from this portion of the body is rare, but it does happen occa- 
sionally and is a severe condition which demands surgical atten- 
tion. 

If the umbilicus remains moist and foul smelling, general 
blood poisoning of the infant may easily follow. Thorough 
dusting with boric acid powder, with possibly a little oxide of 
zinc, will usually effect a cure promptly, but should the con- 
dition continue, which it does only in rare instances, the doctor 
may have to cauterize it. 



CHAPTER XXVIII 
CONTAGIOUS DISEASES 

NEVER under any circumstances knowingly expose a child 
to any of the so-called " childhood diseases." The old 
method of " have the child get them as quickly as possible and 
get over them," has laid the foundation for many chronic dis- 
orders later in life. For instance, eye troubles and running 
ears are often the sequelae of measles; chronic coughs, tuber- 
culosis and bronchitis frequently follow in the wake of whoop- 
ing cough; heart disorders follow diphtheria, while kidney dis- 
ease often follows in the course of scarlet fever. 

CATCHING DISEASE 

Under all circumstances keep the children away from these 
dangerous childhood diseases. When a contagious disease 
breaks out in a school and the little fellow has, along with the 
other pupils, been exposed to it, begin at once systematically 
to keep the nose and throat very clean with such well-known 
sprays as the champhor-menthol-albolene spray, which should 
be used in the nose morning, noon, and night. Throat gargles, 
such as listerine, or equal parts of alcohol and water, help to 
keep the throat in condition to resist the microbic invasion. 

During this anxious time of patient waiting the bowels should 
move every day and the food should be cut down at least a 
third. In other words, moderate eating and a clean bowel 
tract go a long way toward keeping a child well and preparing 
him for an attack of disease. The skin at this time should 
be kept well bathed and free from the accumulated skin secre- 
tions which clog up the sweat glands and otherwise lower the 
vitality. 

Stuffy, close rooms, where the ventilation is poor, not only 

285 



286 THE MOTHER AND HER CHILD 

harbor disease germs, but also lower the vitality of the child. 
Never take your child into a household where there is any form 
of sickness, for it may turn out to be a contagious disease — 
no matter how it began, it must be remembered that many 
contagious diseases, in their earlier stages, much resemble a 
simple cold. 

Measles come on rather gradually, and one might suspect 
that the child was simply suffering from a severe cold in the 
head. 

Scarlet fever usually begins with a sore throat, while chicken- 
pox has very few initial symptoms; usually the first thing 
noted is the rash itself. Diphtheria begins with a sore throat, 
while whooping cough begins very insidiously. 

The most important thing is to keep children away from 
people who are sick, and if a contagious or infectious disease 
is prevalent in the neighborhood discourage the mingling of 
the children in hot, illy ventilated rooms. Put a stop to " par- 
ties " and all similar gatherings. Let the little folks have 
good books, plenty of toys, in a well-ventilated room, and the 
more they keep to themselves at this particular time the better 
they are off. 

THE SPREAD OF CONTAGION 

It is possible to " stamp out " any known disease if only 
proper cooperation takes place and certain sanitary regulations 
are maintained. It is within the memory of most of our readers 
when yellow fever was put to flight and the cause of malaria 
discovered. We learned to screen our camps and no longer 
did our soldiers contract the fever; while the simple covering 
of stagnant pools with oil, together with proper screenage, 
stopped the ravages of malaria. 

Likewise, many of the woeful tragedies of infant summer 
diarrhea and dysenteries have been tracked to the so-called 
" innocent house fly." We have all learned — only recently — 
that if we move the manure pile once in seven days the hatch- 
ing of the maggots may be prevented, and so millions, yes 
trillions, of these carriers of disease may never be born. 

If there is one sweet morsel above another for this fly pest 



CONTAGIOUS DISEASES 2S7 

it is tubercular sputum or feces, and from these feasts they 
go directly to walk over baby's hands, crawl over his cheek, 
and wash their feet in his milk. Proper screenage will prevent 
such contamination of food, such opportunities for carrying 
disease. 

Sunshine, hot water, soap, and fresh air, are the best ordi- 
nary every-day disinfectants. It is possible so to conduct the 
treatment of a contagious or infectious disease that no other 
member of the family may contract it. A few simple but very 
important hints are: 

1. Door knobs are one of the very greatest avenues of con- 
tagion — disinfect them. 

2. Cleanse the hands both before and after attending to the 
sick; first, scrub with stiff brush, soap and water, then dip in 
alcohol. 

3. An epidemic of sore eyes may be stopped by absolute 
" hand disinfection " and using separate towels. 

4. Do not go visiting when you have a " common cold." 

5. Kissing is one of the best ways of spreading many dis- 
eases. 

6. In cases of contagious and infectious diseases completely 
cover all excretions from the body with lime. 

7. Country homes would be as healthy as city homes if the 
privies and stables were screened. 

8. In the country, the well water should be boiled ; one 
infected well may be the cause of the death of a score of 
beautiful children. 

INCUBATION PERIODS 

The incubation period of scarlet fever is from one to seven 
days. 

Measles, ten to twenty days. 
Whooping cough, from one to two weeks. 
Chicken-pox, fourteen to sixteen days. 
German measles, seven to twenty-one days. 
Diphtheria, any time from one to twelve days. 
Mumps, from one week to three weeks. 



288 THE MOTHER AND HER CHILD 

Of all the diseases, measles and chicken-pox are probably the 
most contagious. In scarlet fever and diphtheria, close contact 
is necessary for exposure, while whooping cough can actually 
be contracted in the open air, young babies being particularly 
susceptible. 

TYPHOID FEVER 

Typhoid fever is a disease of the small intestine. Typhoid 
germs accumulate in the little lymph nodes of the small intes- 
tines and that is the reason why we often have so many hemor- 
rhages from the bowel — actual ulcerations take place — and if 
an ulcer is situated in the neighborhood of a blood vessel hemor- 
rhage may result. 

Typhoid fever begins rather insidiously with a slight debility 
and loss of appetite, but if a temperature record is kept the 
fever will be found to rise from one-half to a degree higher 
each day. A steady climb in the temperature curve is noted 
until the end of the first week, when it remains for a week, 
possibly 103 or 104 F. After one week it begins slowly to 
decrease and, if all goes well, the early part of the fourth week 
usually finds the temperature about normal. It is exceedingly 
important that the child be kept in bed during the entire course 
of the disease. The bed pan must be used at each bowel move- 
ment or urination. 

First Week Treatment. During this week the child may feel 
quite well, but he should be kept in bed and sustaining treat- 
ments begun — such as wet-sheet packs and cold frictions to 
the skin (during which time there should always be external 
heat to the feet). The diet must be full and nourishing, but 
all pastries and " knicknacks " should be avoided. Abundance 
of fresh fruit that has been well washed before paring, eggs, 
pasteurized milk, baked potatoes, and toasted bread may be 
taken at regular periods — with an interval of not less than 
five hours beween meals. 

The bowels should be opened in the beginning of the disease 
with a liberal dose of castor oil, after which daily colonic irri- 
gations should be employed. These enemas should be given 
at least once a day, the temperature being about that of the 



CONTAGIOUS DISEASES 289 

body, with a smaller terminal enema about five degrees cooler 
at the close of each bowel cleansing. 

Second Week Treatment. The normal temperature at this 
time is no longer 98.6, it is 101.5 F. This fever is essential to 
the curative and defensive processes of the body; and while 
we do not care to have the fever fall below 101.5, at the same 
time nothing is to be gained by allowing the fever to go up 
much above 102.5 or 103 degrees F. And so, during the second 
week, while the disease is at its height, we make frequent use 
of the wet-sheet pack, always remembering that the extremi- 
ties must be kept warm and never permitting the skin to become 
blue or mottled while the cold treatment is being administered. 
Since the real disease is localized in the small intestine, we will 
now describe a very important treatment for the diseased bowel 
— and one which is also very useful in combating high tem- 
perature. 

The Cooling Enema. The temperature of this enema begins 
one degree higher than that of the body (supposing the body 
temperature to be 103, the temperature of the enema would 
start at 104 F.). This is allowed to flow into the colon and out 
again, under low pressure, without disturbing the patient, by 
means of a glass tube connection (See Fig. 15). The tempera- 
ture is quickly brought down to 100, then to 98, then to 90, 
usually finishing up at 80 or 85 F. The water is allowed to enter 
the rectum slowly through a soft rubber catheter (not a hard 
rectal point), and as it comes out it will be noted that the water 
is very warm, sometimes registering 105, and it is needless to add 
that if the water goes in at 80 and comes out at 105 F., much 
heat has been taken from the body; and so, of all the treat- 
ments we have to suggest for typhoid fever, the one just men- 
tioned is possibly the most important. When it is necessary 
to keep up this enema for an hour or two, the cool water may 
cramp the bowels, but this may be entirely obviated by applying 
hot compresses to the abdomen. 

Another treatment of great importance in this second week 
is the cold abdominal compress. Much fever is occasioned in 
the abdomen because it is the seat of disease, and the much 
dreaded hemorrhages which often cause the death of the 



290 THE MOTHER AND HER CHILD 




Fig. 15. The Cooling Enema 



CONTAGIOUS DISEASES 291 

patient are usually avoided by the use of abdominal com- 
presses — wrung out of water at 55 F. — the temperature of 
ordinary well water — and changed every twenty minutes. 

I recall one mother in my dispensary practice who was so 
poor she could not afford a nurse, her only helper being a son 
twelve years old. A nurse went to the house twice each day 
and taught this lad of twelve years to give his mother the 
cooling colonic irrigation; he was also taught to warm up the 
abdomen by a hot application and afterwards to apply the cold 
compresses. The mother made a good recovery. 

During this second week the diet should be sustaining. It 
should consist of boiled milk, eggs, fresh fruit and fresh fruit 
juices, dextrinized grains (hard toast, toasted corn flakes, 
shredded wheat biscuits, etc.). The mouth should be kept 
scrupulously clean, for in all the infectious and contagious dis- 
eases there is always the possibility of gangrene in the mouth 
if it is neglected. 

Third Week Treatment. This is the week we look for hem- 
orrhage from the bowel unless the abdomen has been well 
treated during the second week; and even so, the cool com- 
presses to the abdomen will be continued well into the third 
week — also the daily or semi-daily enema. The skin is kept, 
in good condition with soap washing and friction baths, and a 
fairly liberal diet is maintained. During the whole course of 
the disease the skin is never allowed to get blue or mottled, 
being quickly restored to the normal red color by the mustard 
sheet bath, the short hot-blanket pack, or the dry-blanket pack 
with hot-water bottles. Under no circumstances let the child 
leave the room or his bed for at least another week. 

MUMPS 

Infants are rarely affected with mumps. It is a disease of 
the salivary glands and (as a rule) is usually preceded by pain 
between the ear and the angle of the jaw, accompanied in a 
short time by swelling and temperature. It is distinctly con- 
tagious even during the incubation period. There is much ten- 
derness on pressure, and chewing is difficult and may be impos- 
sible. It usually occurs on the face and only one side may be 



292 THE MOTHER AND HER CHILD 

affected. The bowels should be kept open, the mouth should 
be kept clean, and the side of the face should be protected by 
a layer of cotton held in place by bandages. 

Hot fomentations may be applied if the pain is severe. The 
electric light bulb on an extension cord, that was mentioned 
in connection with earache, is very comforting in this con- 
dition. 

Isolation should be maintained for ten days or two weeks 
after all symptoms have disappeared. 

SCARLET FEVER 

Scarlet fever is one of childhood's most dreaded diseases 
because of, first, its long quarantine; second, its terrible possi- 
bilities of contagion; and, third, its sequelae. 

Absolute quarantine is necessary until ten days after the last 
signs of desquamation have disappeared. 

This disease is always alarming because of the possibilities 
of its sequelae — the danger of pneumonia, inflammation of 
the ears, abscesses of the glands of the neck, and nephritis 
(inflammation of the kidneys). 

Scarlet fever is highly contagious at any time during its 
onset and course. Among the first symptoms of the disease 
are sore throat, swollen glands, fever, etc. Vomiting on a 
street car or at the movie may spread the disease to more 
than one child who might otherwise have escaped. One child 
who may have only a very light form of the disease may give 
it to another child in the most severe form. Any such group 
of classic symptoms — vomiting, fever, rapid pulse, and sore 
throat — should cause any parent immediately to isolate the 
little sufferer for several days — awaiting the " rash " — which 
usually puts in its appearance after three or four days of 
increasing temperature. 

This rash has an appearance " all of its own," unlike any 
other. Because the fine " meal-like " red points are in such 
close proximity, the skin assumes a smooth " lobster red " 
color that is never to be forgotten. After three days of increas- 
ing redness, the color begins slowly to fade, and after four 
or five days of this fading a peculiar peeling takes place, whose 



CONTAGIOUS DISEASES 293 

scales vary in size from a small fleck to casts of the whole of 
the soles of the feet and the palms of the hands. 

During the height of the disease, the throat is very red, 
the tonsils are not only inflamed, but covered over with white 
patches, the head aches and the tongue possesses a peculiar coat- 
ing through which peep the red points of the swollen papillae, 
presenting the classic " strawberry tongue " of scarlet fever. 

After ten days the fever disappears and the " real sick " 
stage of the disease is in the past. 

Each morning of the ten previous days a small dose of Epsom 
salts is usually administered and the itching, which so often 
accompanies the rash, is relieved by carbolized-water sponge 
baths. 

The nose, throat, and ears receive daily care — sprays to the 
nose and gargles to the throat, as well as special swabbing to 
the tonsils. 

The physician in charge of the case will note the urinary 
findings, guard the heart and kidneys, prevent the spreading of 
the scales of desquamation by frequent rubbing of the skin with 
oil, and otherwise work for the future well-being of the 
patient. 

MEASLES 

Measles, one of the most common diseases of childhood, is 
not to be regarded lightly, for very often its sequelae — run- 
ning ears, weak eyes, and bronchial coughs — may prove very 
serious and troublesome. Tuberculosis of the lungs not infre- 
quently follows in the wake of measles. The early symptoms 
of measles are so mild that often the child is out of doors, at 
school, or about his usual play, until the second or third day 
of the fever. He was supposed merely to be suffering from 
a simple " cold in the head." 

On the third or fourth day the patient begins heavy sneez- 
ing and wears a stupid expression; and it is then that the 
mother ascertains that his temperature is perhaps 101 to 102 F. 
He is put to bed and the next day the rash usually appears. The 
rash is peculiar to itself, not usually mistaken for anything else, 
being a purplish red, slightly elevated, flattened papule, about 



294 THE MOTHER AND HER CHILD 

the size of a split pea. The coughing, which is very annoying, 
usually remains until about the seventh or eighth day — at 
which time the fever also disappears. 

The bowels must be kept open ; a daily bath be given — in 
which has been dissolved a small amount of bicarbonate of 
soda (simple baking soda) — after which an oil rub should 
be administered. The nose should be frequently sprayed with 
three per cent camphor-menthol-alboline spray, while the throat 
is gargled with equal parts of alcohol and water. The feet 
should be kept warm by external heat, while the physician in 
charge may order additional attention to the chest, such as a 
pneumonia jacket, etc. 

Care should be taken to guard against " catching cold," for 
bronchitis or pneumonia is quite likely to develop in many cases 
of measles. The eyes should be protected by goggles and the 
room should be darkened; under no circumstances should the 
little patient be allowed to read. Carelessness in this respect 
may mean weakened eyesight all the rest of his life. Until two 
weeks after the rash has disappeared, the little fellow should 
be kept by himself, for the desquamation keeps up almost con- 
tinuously during this time. 

The food during the course of the disease is a liquid and soft 
diet. Children should never be allowed to go to a party or 
gathering with a cold in the head ; the mothers of a group of 
small children will never forget the time that one certain 
mother allowed her little fellow to attend a party with " simply 
a cold in the head." He laughed, talked, and sneezed during 
the afternoon and when he went home the rash appeared that 
night, while eight of the ten exposed children came down with 
measles during the next two weeks. 

CHICKENPOX 

The incubation period of chickenpox is from ten to seven- 
teen days. It is a mild disease, with a troublesome rash con- 
sisting of widely scattered pimples appearing over the scalp, 
face, and body. These pimples soon became vesicles (small 
blisters), -which in turn quickly become pustular, afterwards 
drying up with heavy crust formation. Severe itching which 



CONTAGIOUS DISEASES 295 

attends these pustules may be greatly allayed by either the 
daily carbolic-acid-water bath or a baking-soda bath. The itch- 
ing must be relieved by proper measures, for if the crust is 
removed from the top of the blebs by scratching, a scar usually 
results. The bowels should be kept open, the diet should be soft. 
Rigidly isolate, for chickenpox is highly contagious. 

SMALLPOX 

This disease occurs oftenest during the cold season. It spares 
no one unless vaccinated, attacking children and adults alike. 
The early symptoms are : headache, pain in the back, high fever, 
vomiting, and general lassitude. In many respects these resem- 
ble the symptoms of the grippe, while on the third day the 
eruption appears. The pimples are hard and feel like shot under 
the skin. Within a day or two these shotlike pimples have 
grown and pushed themselves beyond the skin into little conical 
vesicles which soon turn to pus. By the eighth or ninth day 
crusts are formed over the vesicle, beginning to fall off about 
the fifteenth day. 

Patients are quarantined usually eight weeks and when a case 
of smallpox in the home breaks out everyone in the family 
should be revaccinated. The strictest isolation is important from 
the first of the disease. 

We will not enter into the treatment of smallpox, for medical 
aid is sought at once and usually the patient is removed to 
a special isolation hospital. 

VACCINATION 

The history of the change brought about in the Philippines 
since vaccination has been introduced is an argument of itself 
which ought to convince the most skeptical of the value of 
vaccination. By all means, every child in a fair degree of health 
should be vaccinated. It is wise to vaccinate babies before the 
teething period — from the third to the sixth month. Babies 
with any skin trouble or suffering from malnutrition, but not 
living in a smallpox district, should be vaccinated during the 
second year. In young babies, under six months, the leg Is the 
proper place to receive the vaccination. 



296 THE MOTHER AND HER CHILD 

If proper surgical cleanliness is practiced and ample protec- 
tion is afforded in after dressing, vaccination need not be a tax- 
ing process. The child suffers from general lassitude — a little 
drowsiness with loss of appetite and a small amount of fever — 
but this passes off in a reasonable length of time, especially if 
he is not overfed and his bowels are looked after. On the sec- 
ond or third day after vaccination a red papule appears which 
soon grows larger, and, after five or six days, it becomes filled 
with a watery fluid. By the tenth day it has the appearance of 
a pustule about the size of a ten-cent piece, surrounded by a 
red areola about three inches in diameter. At the end of two 
weeks the pustule has dried down to a good crust or scab, in 
another week it falls off, leaving a pitted white scar. 

If the vaccination does not take, it should be repeated after 
an interval of two months. 

DIPHTHERIA 

Diphtheria is a disease much dreaded during childhood and 
adolescence. It may attack any age — even little babies are 
susceptible. It begins with a general feeling of heavy, drowsy 
lassitude with a sore throat. White spots appear on the tonsils 
which may resemble a simple follicular tonsillitis, while in a 
short time white patches spread over the throat and tonsils. 

It is not at all uncommon for this membrane to attack the 
nose, producing a bloody, pustular discharge; and when it does 
attack the nose, it is none the less contagious and must be re- 
garded just as seriously. A physician is called at once, and, 
not only to the child, but to the other members of the family, 
antitoxin is immediately administered. The disease runs a regu- 
lar course and its most dangerous complication is the membrane 
which forms in the larynx and threatens to suffocate the child 
unless prompt intubation is performed — the slipping of a silver 
tube in the larynx to prevent suffocation and death. The early 
use of antitoxin greatly lessens all these serious complications. 

Care must be exercised to prevent sudden heart failure; and 
this is done by raising the child to an upright position with the 
utmost care; while you insist upon him lying quietly upon his 
back or his side, long after the disease has left his throat. While 



CONTAGIOUS DISEASES 297 

the throat or nose is the seat of disease, the toxins from these 
most dreaded diphtheritic microbes spread through the lymph 
channels and the blood vessels to the .heart itself — so weaken- 
ing that organ that it sometimes suddenly fails, or becomes more 
or less crippled for life. These serious results are to be pre- 
vented by the science of good nursing and the prompt use of 
antitoxin. In these days the " Schick test " may be administered 
for the purpose of ascertaining whether one is susceptible to 
contracting diphtheria. 

A physician is always in charge of diphtheria, and he will 
supply directions for the bowels, the diet, and the sprays for the 
nose and throat, and the general well-being of the suffering 
child. Isolation and quarantine should continue for two weeks, 
and in bad cases three weeks, after the membrane has disap- 
peared from the throat. 

WHOOPING COUGH 

A child suffering from a continuous cough, particularly if it 
is accompanied by a whoop or a condition which is so often 
seen in children who cough — not able to stop ■ — should not be 
taken to church, nor to the movies, nor allowed to go to school ; 
neither should he be allowed to leave his own yard. The aver- 
age duration of the disease is usually six weeks. The child 
should have an abundance of fresh air, should spend much of 
his time out of doors, and while in the house should avoid dust 
of every kind ; at night he should not be exposed to drafts. Call 
the physician early in the case and he may attempt to thwart 
the progress of the disease by certain administrations of vaccine 
medication. 

In very bad cases, where a young child cannot catch his breath 
and gets blue in the face — which, fortunately, is uncommon — 
he should be slapped in the face with a towel wet in cold water ; 
or, he may be lifted into a tub of warm water, then quickly in 
cold water, then back into the warm, etc. Hygienic measures 
should prevail, such as keeping the bowels open, the skin clean, 
and the use of the usual throat gargles and nasal sprays. Do 
not be misguided by the old-time thought that whooping cough 
must run its course; for, if medical aid is promptly secured, the 



298 THE MOTHER AND HER CHILD 

disease may often be cut short and the severe paroxysms greatly 
lessened. 

EYE INFECTIONS 

Not long ago while in North Dakota near Canada, we took a 
trip one day just over the border to visit several villages of Rus- 
sian peasants. We found the boys and girls of nearly the entire 
village suffering from trachoma — a dangerous, infectious dis- 
ease of the eyes which spreads alarmingly from one child to 
another. 

We saw the disease in all of its varying degrees among the 
children. Some of them had swollen, reddened lids. A dis- 
charge of pus was coming from the eyes of others, and they 
could not look toward a light or the sun. This disease is spread 
in a hundred different ways — through the common use of wash 
basins, towels, handkerchiefs, tools, toys, door knobs, gates, etc., 
and that is the reason why these isolated villages of foreign 
people who could neither read nor write the English language 
were nearly all so sorely afflicted. 

The ordinary condition of " catching cold in the eye " (." pink 
eye ") is just as infectious as the trachoma which we have men- 
tioned, although it is more of an acute disorder and nothing like 
so serious. 

In all such cases a physician is to be called immediately, iso- 
late the patient, and give strict attention to carrying out the 
doctor's orders. 

Another form of inflammation of the eye which was men- 
tioned in a previous chapter, is the inflammation of the eye of 
the newborn. 

In most civilized districts at the present, especially where the 
cases are attended by a physician, the eyes of all newborn 
babies are treated with either argyrol or silver nitrate. Just as 
soon as defective sight is discovered in the child the eyes should 
be examined at once and proper glasses fitted. While the glim- 
mer and shimmer of moving pictures may seriously interfere 
with the child's vision, on the other hand, this very thing often 
discovers the defect in the eyesight earlier than it would other- 
wise be found out. 



CONTAGIOUS DISEASES 299 

RUNNING EARS 

Inflammation of the ears was fully covered in our discussion 
of adenoids and tonsils, but we would like to add at this time 
that under no circumstances should a running ear be regarded 
lightly. A chronic mastoiditis (inflammation of the middle ear) 
often follows measles, scarlet fever, adenoid infection, and in- 
flammation of the tonsils. The attention of a specialist should be 
called to it and his instructions most carefully carried out; for, 
when we have a sudden stopping of the discharge from the ear 
with high fever and pain behind the ear, sometimes an operation 
is imperative or the child may be lost. 



CHAPTER XXIX 
RESPIRATORY DISEASES 

NEXT to digestive disturbances, babies suffer more fre- 
quently from respiratory disorders — colds, bronchitis, and 
pneumonia. In fact, during very early infancy, pneumonia 
heads the list of infant deaths, only to be displaced a few months 
later by that most dreaded summer disease — diarrhea. 

Little tiny babies are so helpless — they are so dependent upon 
their seniors for life itself — that our responsibility is indeed 
great. We should put forth our best endeavor to avoid and pre- 
vent common colds. Among all the common maladies that afflict 
the human race " colds " probably head the list ; and, in the case 
of babies and the younger children, the common colds often go 
on into coughs, croup, bronchitis, and even pneumonia. 

WHY BABIES CATCH COLD 

1. Someone has brought the infection to him. 

2. Somebody coughed in his face. 

3. Germ-laden hands have handled the baby. 

4. He has drunk from an " infected " glass. 

5. There was not enough moisture in the air. 

6. Somebody wiped his face with an infected towel. 

7. Baby was allowed to play on the cold floor. 

8. Baby's lowered vitality could not stand the combined strain 
of overeating and clogged up bowels. 

9. Baby was kissed in the mouth by a " cold-germ " carrier. 

10. Baby was dressed too warmly — and then taken out. 

11. Somebody carelessly breathed in baby's face, 

12. He slept in a stuffy room. 

300 



RESPIRATORY DISEASES 301 

13. His extremities got chilled. 

14. Baby has adenoids or diseased tonsils. 

Babies should not be allowed to sit or play on cold, drafty 
floors. They may play on mother's bed whose open side is 
protected with high-back chairs, or they may play in their own 
bed whose raised sides are sheltered by blankets. 

It is possible for a mother so to disinfect her hands, and so 
garb herself with clean, washable garments, that, although she 
may be suffering from an acute cold, she may continue to care 
for her baby and the baby need not contract the cold. 

CORYZA COLD IN THE HEAD 

This most annoying ailment, a cold in the head, is particularly 
hard on babies because the obstruction of the nasal passages not 
only makes breathing difficult, but renders nursing well-nigh im- 
possible. 

The throat end of the eustachium tube (the ear tube) is found 
in the upper and back part of the throat, just behind the nose. 
The infection of the cold extends from both the nose and throat 
and there results a spreading inflammatory process on through 
these ear tubes into the middle ear itself. Now if this tube 
swells so much that it entirely closes, as so often happens in 
cases of " cold in the head " as well as in constant irritation 
from adenoids, then may follow a vast train of difficulties — 
earache, mastoiditis, etc. — with the result that the tiny bones 
in the middle ear which vibrate so exquisitely may become 
ankylosed (stiffened) and deafness often follow. Everything 
known must be done to prevent baby's catching " cold in the 
head." If the sinuses become infected it may also lead to 
serious consequences. 

When the nose becomes clogged it may be opened up by re- 
peatedly disinfecting the inside of the nose with oily sprays such 
as simple albolene or camphorated-albolene spray. 

The bowels should be quickly opened by castor oil, and the 
feedings should be cut down at least two-thirds or one-half. 

Public drinking cups should always be avoided and kissing the 
baby be tabooed. 



302 THE MOTHER AND HER CHILD 

GRIPPE 

The treatment of influenza in infancy and childhood is to avoid 
contact with an older person suffering with the grippe. Ordi- 
narily, the so-called " grippe " is a common, mixed infection — 
not true influenza. Coryza and cough are the chief respiratory 
symptoms which attend these widespread epidemics. Often 
vomiting and diarrhea are seen in the young sufferers. 

In cases of grippe put the child to bed and call the doctor. In 
the case of the older children, the treatment and care to be rec- 
ommended has been fully outlined by the author in the little 
work entitled The Cause and Cure of Colds. 

Complications from the grippe are very frequent in children 
— such as severe diarrhea, enlarged glands of the neck, running 
ears, bronchitis, pneumonia, and sometimes tuberculosis. 

Every effort should be put forth to isolate and quarantine the 
first member of the family to be stricken with grippe so that the 
remaining members may, if possible, escape an uncomfortable 
and unhappy siege. 

SORE THROAT 

The danger of permanent deafness which so often follows a 
sore throat as well as a cold in the head, should cause every 
mother or caretaker earnestly to begin treatment at the very first 
sign of a sore throat. When a little baby gulps or cries on swal- 
lowing, a sore throat should always be suspected and remedial 
measures promptly instituted. 

A most convenient article with which to examine an infant's 
throat is a small pocket flashlight. The pillars of the throat or 
the tonsils or both may be much inflamed, and since tonsillitis, 
diphtheria, and scarlet fever all begin with a sore throat, it is 
wise early to seek medical counsel in order that the differential 
diagnosis may be promptly made. We urge the mother, as a 
rule, not to attempt to diagnose severe cases of sore throat. 
Send for the physician. 

Tonsillitis is a severe form of sore throat which, fortunately, 
rarely troubles tiny infants; but for every sore throat, while 
waiting for medical help to arrive, lay your plans to empty the 



RESPIRATORY DISEASES 3°3 

bowels, diminish the quantity of the food, swab or spray the 
throat, and later closely follow the physician's advice concerning 
the general treatment of the child. 

ADENOIDS 

Adenoid growths appear as grape-like lymphoid formations 
located in the upper and posterior-nasal pharynx. These ade- 
noids secrete a very toxic, thickened fluid, which slowly makes 
its way down along the back wall of the throat, and reddens and 
inflames first the anterior and posterior pillars of the throat and 
then often inflames and enlarges the tonsils. 

Adenoids not only obstruct the respiratory passage way to the 
throat and lungs, but they also exert a harmful influence on the 
general physical and mental development of the child. 

It is nothing less than criminal for heedless parents to allow 
adenoid growths to remain in the child's post-nasal pharynx. 
The little fellow's face is disfigured, more or less for life, his 
mentality dulled, while he is compelled to breathe through his 
mouth. 

An almost miraculous change often follows the complete re- 
moval of these obstructive adenoids — the child takes a renewed 
interest in everything about him. More oxygen finds its way to 
the tissues, his face takes on better color, he gains in weight, 
in fact, there appears to be a complete rejuvenation mentally 
and physically. 

The signs or symptoms of adenoids are mouth breathing, rest- 
lessness at night, snoring, recurring colds, nasal discharge, swell- 
ing of the glands of the neck, poor nutrition, loss of appetite, 
bed wetting, impaired hearing, lack of attention, and mental 
dullness. The removal of adenoids is neither a serious or diffi- 
cult procedure, and they may safely be removed at any age. 

DISEASED TONSILS 

Tonsils which remain permanently enlarged and show signs 
of disease and debilitation — filled crypts — may be removed as 
early as the fourth or fifth year, if necessary. If proper treat- 
ment does not improve the tonsils as the child grows older, their 
removal should seriously be considered. The tonsils may serve 



304 THE MOTHER AND HER CHILD 

some special secretory or defensive function during the first few 
years of life and we think best, therefore, not to advise their 
removal — except in extreme cases — until the child is at least 
four or five years old. 

When it is necessary to attack the tonsils, they should be 
thoroughly dissected out — not merely burned or clipped off. 
If they are properly removed, the danger of heart trouble, 
rheumatism, and many other infections may be considered as 
greatly lessened. 

After five years of age the normal tonsils should begin to 
shrink, and at about the beginning of adolescence they should 
be no larger than a small lima bean, hidden almost completely 
out of sight behind the pillars of the throat. While healthy ton- 
sils may serve some useful purpose even in the adult, it is almost 
universally conceded that the thoroughly bad and diseased tonsil 
is utterly useless to the body — only an open gateway for the 
entrance of infection. 

BRONCHITIS 

A very common disorder of early infancy and childhood is 
bronchitis — an inflammation of the bronchial tubes — 'accom- 
panied by severe coughing. Its tendency to pass into pneumonia 
renders it a disease for skilled hands to treat — a disorder hardly 
safe for even the well-meaning mother to undertake to manage 
without medical advice and help. And since bronchitis is usually 
accompanied by alarming symptoms of high fever, weakened 
heart, embarrassed breathing, mottled or blue skin, green stools, 
troublesome cough, disturbed sleep, " stopped up nose," and 
" choked up throat," it is of utmost importance not only to 
seek medical aid early, but also that the mother, herself, should 
have definite ideas concerning the proper manner of doing the 
following things in the line of treatment: 

1. Making and applying a mustard paste. 

2. The fashioning of an oil-silk jacket. 

3. Improvising a steam tent. 

4. Flushing out the colon, and a score of other things which 
the watchful doctor may want given any moment. 



RESPIRATORY DISEASES 305 

Mustard Pastes are prepared by mixing one part of mustard 
and six parts of flour in warm water and applying to the chest 
between two pieces of thin muslin. It is left on just seven 
minutes and then talcum powder is thickly sprinkled on the 
moist, reddened skin; this powder quickly absorbs all the mois- 
ture and leaves the skin in a good condition — ready for another 
paste in three hours if it is so ordered. 

The Oil-Silk Jacket, or pneumonia jacket, consists of three 
layers — the inside of cheesecloth, an inner thin sheet of cot- 
ton wadding, and an outside layer of oil silk (procurable at any 
drug store). It should open on the shoulder and under the arm 
on the same side. It is worn constantly (change for fresh 
cheesecloth and cotton every day) during the inflammatory 
stage; it is removed only during the mustard pastes. 

A Steam Tent may be prepared by placing a sheet over the 
infant's crib and allowing steam to enter from a large paper 
funnel placed in the nose of a tea kettle of boiling water kept 
hot on a small stove of some sort. 

The mattress and bedding are covered with rubber sheeting 
and the infant's clothes protected from moisture. The baby 
should remain in this steamy atmosphere ten minutes at a time. 

Another method is to hold baby in arms near the large end 
of a big funnel placed in a tea kettle on the gas stove or range, 
and then have an assistant help hold a sheet tent over both the 
mother and babe. Or the baby carriage may be placed over a 
small tub of water into which are dropped several hot bricks. 
A sheet canopy spread over the carriage holds the steam in and 
baby reaps the benefits of the warm moisture. 

Colonic Flushing is necessary when green stools accompany 
bronchitis. A well-lubricated end of a large Davidson's syringe 
is inserted into the rectum, and with the hips of the baby brought 
to the edge of a basin (the heels held in the hands of the assist- 
ant), water is forced into the rectum. Not more than one ordi- 
nary cup of water should be introduced at any one time. After 
expulsion, another may be gently injected. 

The diet in bronchitis is always reduced so that no extra 
work will be thrown on the already overtaxed constitution of 
the child. 



306 THE MOTHER AND HER CHILD 

'Absolute rest is necessary and perfect quiet should prevail. 
The humidity of the room should not be lower than 50 at any 
time, while the air should be moderately cool and fresh. 

Numerous other details which may be necessary in the man- 
agement of bronchitis will be directed by the physicians and 
nurses in charge of the case. 

SPASMODIC CROUP 

It is believed that children with enlarged tonsils and adenoids 
are much more subject to croup than others. Although very 
sudden in its onset and very alarming, spasmodic croup, for- 
tunately, is seldom dangerous. A little child goes to bed in 
apparently normal condition and wakes up suddenly with a 
coarse metallic cough, difficult breathing, and with a distressed 
expression on the face. 

Alternate hot and cold compresses should be applied to the 
throat — first the hot cloths (wrung from very hot water) being 
applied over the throat, which should he covered with a single 
thickness of dry flannel. Then after three minutes of the hot 
cloths a very cold cloth is applied to the skin itself for one half 
minute; then more of the hot compress, followed again by the 
short cold, until five such changes have been made. A bronchitis 
tent should be quickly improvised so that the child can be 
" steamed." 

Vomiting must be produced by kerosene (three or four drops 
on sugar), alum and molasses, or ipecac (ten drops every fifteen 
minutes). Some remedy must be administered continuously 
until free vomiting occurs. A good dose of castor oil should be 
given after the spasm. Suitable treatment should be adminis- 
tered through the day to prevent a recurrence of the attack the 
next night. 

The general vital resistance should be raised by outdoor life, 
improved circulation, good food; adenoids if present, should 
be removed. 

Medical advice should be sought in every case of severe croup, 
for membraneous croup usually is indicative of diphtheria, and 
the diagnosis is important, as on it hangs the determination of 
the administration of antitoxin. 



RESPIRATORY DISEASES 307 

PNEUMONIA 

Pneumonia is always a serious disease. It is accompanied by 
high fever, painful, very short cough, and rapid breathing with 
a moving in and out of the edges of the nose as well as the 
spaces between the ribs. The possibilities of complications are 
always great — the dangers are many — so that the combined 
watchfulness of both the mother and a proficient trained nurse 
are required; not to mention the skill of the physician. 

The steam tent, the mustard paste, the oil-silk jacket and the 
colonic flushing (described earlier in this chapter) may all be 
asked for by the physician in his untiring efforts to prevent dan- 
gerous complications during the course of the disease. 

Plenty of moderately cool, fresh air (without drafts) is of 
great benefit. Never allow blue finger tips, or cold ear tips to 
exist; send at once for the doctor and administer a hot bath, or 
wrap in a sheet dipped in hot mustard water while awaiting his 
arrival. No mother should think of attempting to carry her 
baby through an attack of bronchitis or pneumonia without the 
best medical help available. 



CHAPTER XXX 
THE NERVOUS CHILD 

WHILE each child possesses an individuality all its own, 
nevertheless, there are certain general principles of 
psychologic conduct and family discipline which are more or 
less applicable to all children. The so-called nervous child, in 
addition to the usual methods of child culture, stands in need 
of special attention as concerns its early discipline and training. 
This chapter will, therefore, be devoted to special suggestions 
with regard to the management and training of those children 
who are by heredity predisposed to nervousness, over-excitabil- 
ity, and who possess but a minimum of self-control. 

HEREDITARY NERVOUSNESS 

The so-called nervous child — all things equal — is the child 
who is born into the world with an unbalanced or inefficiently 
controlled nervous system; and while it is all too true that the 
common nursery methods of " spoiling the child " are often 
equally to blame with heredity for the production of an erratic 
disposition and an uncontrolled temper, nevertheless, it is now 
generally recognized that the foundation of the difficulties of 
the nervous child reaches back into its immediate and remote 
ancestral heredity. 

I no longer doubt but that many of these babies with a bad 
nervous heredity, who are born predisposed to Saint Vitus' 
dance, bad temper, chronic worry, neurasthenia, and hysteria 
could be spared much of their early troubles and later miseries 
by prompt and proper methods of early nursery discipline. 

These nervous babies are born into the world with an ab- 
normal lack of self-control. Their " inhibition control " over 
the natural and spontaneous tendency of the nervous system to 

308 



THE NERVOUS CHILD 309 

manifest its inherent impulses and passing whims is decidedly 
deficient. The child is unduly sensitive, whines, hollers, or flies 
into a violent rage when its will is crossed in the least degree. 
Such a child sometimes keeps its mother living in constant terror 
because, when its will is crossed in any particular, it will scream 
and hold its breath until it turns black in the face and some- 
times actually goes into a convulsion. 

In dealing with these unfortunate little ones, fathers and 
mothers, while they should be firm and persistent in their meth- 
ods of correction, should also be kind and patient; fully recog- 
nizing that whatever undesirable traits the little ones manifest 
they have come by honestly — these naughty tendencies being 
the result either of heredity or spoiling, for both of which the 
parents stand responsible. 

EARLY TRAINING 

One of the very first things that a child, especially the nervous 
child, should learn is that crying and other angerful manifesta- 
tions accomplish absolutely nothing. The greatest part of the 
successful training of the nervous child should take place before 
it is three and one-half years of age. It should early learn to 
lie quietly in its little bed and be entirely happy without receiv- 
ing any attention or having any fuss made over it. It should 
not become the center of a circle of admiring and indulgent 
family friends and caretakers who will succeed in effectually 
destroying what little degree of self-control it may be fortunate 
enough to possess. 

When the little one is discovered to be nervous, fretful, im- 
patient, and easily irritated early in the morning, it should be 
left alone in its bed or in the nursery until it quiets down. If 
it has a good, healthy crying spell, leave it alone. Let it early 
get used to living with itself — teach the little fellow to get 
along with the world as it is — and you will do a great deal 
toward preventing a host of neurasthenic miseries and a flood 
of hysterical sorrows later on in life. 

You must not expect to train the nervous child by the simple 
and easy methods which are successful in the case of a normal 
child ; that is, you cannot repeat a simple discipline two or three 



310 THE MOTHER AND HER CHILD 

times and have the child learn the lesson. In the case of the 
high-strung nervous child it requires " line upon line and pre- 
cept upon precept ; " for, whereas a normal child will respond to 
a certain discipline after it is repeated a half dozen times, the 
nervous child will require the persistent repetition of such a 
discipline from twenty-five to one hundred times before the 
lesson sinks into his consciousness sufficiently to enable 
him to gain control of his erratic and unbalanced nervous 
mechanism. 

SPOILING THE CHILD 

As bad as all spoiling methods are in child culture, they are 
decidedly disastrous — almost fatal — in the case of the nervous 
child ; and yet it is these delicate, sensitive, cute little things that 
are the very ones who are most frequently the worst spoiled. 
Nervous children simply must not be played with all the time. 
They must be by themselves a great deal, at least this is true 
in their earlier years. 

The nervous baby must early learn absolute respect for au- 
thority, so that what it lacks in its own nervous control may be 
partially made up for by parental suggestion and discipline. Of 
course, as suggested in a later chapter, the more ideal methods 
of suggestion, education, and persuasion should be employed in 
your efforts to secure obedience and promote self-control; but, 
when through either the deep-rooted incorrigibility of a child, 
or the inefficiency of the parent's efforts in the employment of 
suggestion — no matter what the cause of the failure of your 
ideal methods to control temper, stop crying, or otherwise put 
down the juvenile rebellion, whether the child has been spoiled 
on account of company, sickness or ^through your carelessness — 
when you cannot effectively and immediately enforce your will 
any other way, do not hesitate to punish; spank promptly and 
vigorously and spank repeatedly if necessary to accomplish your 
purpose. You must not fail in the case of the nervous child to 
accomplish exactly what you start out to do. 

When the little fellow wakes up in the night and cries, see 
if he needs anything and administer to him. If you have pre- 
viously tried the method of letting him " cry it out," which is 



THE NERVOUS CHILD 311 

usually entirely sufficient in the case of a normal child, and if 
such treatment does not seem to cure him, then speak to him 
firmly, give him to understand that he must stop crying, and 
if he does not, turn him over and administer a good spanking — 
and repeat if necessary to get results. In dealing with a nervous 
child we must follow the directions on the bottle of the old- 
fashioned liniment " rub in until relief is obtained." 

No " spoiling practices " should be countenanced in the case 
of nervous children. They should be taught to sleep undis- 
turbed in a room in the presence of usual noises. They should 
not be allowed to grow up with a sleeping-room always darkened 
by day and a light to sleep by at night. They should be taught 
to sleep on without being disturbed even if someone does enter 
the room; they should be taught to sleep normally without hav- 
ing to quiet and hush the whole neighborhood. 

PLAYMATES 

The early play of nervous children should be carefully super- 
vised and organized. Under no circumstance should they be 
allowed exclusively to play with children younger than them- 
selves. They must not be allowed to dictate and control their 
playmates; it is far better that they should play at least a part 
of the time with older children who will force them to occupy 
subordinate roles in their affairs of play ; in this way much may 
be accomplished toward preventing the development of a selfish, 
headstrong, and intolerant attitude. When the nervous child 
is miffed or peeved at play and wants to quit because he cannot 
have his way, see to it that he quickly takes his place back in the 
ranks of his playfellows, and thus early teach him how to 
react to defeat and disappointment. The nervous child must 
not be allowed to grow up with a disposition that will in some 
later crisis cause him to " get mad and quit." 

If the nervous baby has older brothers and sisters, see to it 
that he does not, through pet and peeve and other manifestations 
of temper, control the family and thus dictate the trend of all 
the children's play. Early train him to be manly, to play fair, 
and when his feelings are hurt or things do not go just to his 
liking, teach him, in the language of the street, to be " game." 



312 THE MOTHER AND HER CHILD 

It is equally important that the little girls be taught in the same 
way how to take disappointment and defeat without murmur or 
complaint. 

TEACHING SELF-CONTROL 

When nervous children grow up, especially if their parents 
are well to do, and they are not forced to work for a living, 
they are prone to develop into erratic, neurasthenic, and hys- 
terical women, and worrying, inefficient, and nervous men ; and 
in later years they throng the doctor's offices with both their 
real and imaginary complaints. These patients always feel that 
they are different from other people, that something terrible is 
the matter with them or that something awful is about to hap- 
pen to them. Their brains constantly swarm with fears and 
premonitions of disease, disaster, and despair, while their other- 
wise brilliant intellects are confused and handicapped because of 
these " spoiled " and " hereditary " nervous disturbances — with 
the result that both their happiness and usefulness in life is 
largely destroyed. 

The fundamental abnormal characteristic of that great group 
of nerve-patients who throng the doctor's office is sensitiveness, 
suggestibility, and lack of self-control. Sensitiveness is nothing 
more or less than a refined form of selfishness, while lack of 
self-control is merely the combined end-product of heredity and 
childhood spoiling. I am a great believer in, and practitioner 
of, modern methods of psychological child culture, but let me 
say to the fond parent who has a nervous child, when you have 
failed to teach the child self-control by suggestive methods, do 
not hesitate to punish, for of all cases it is doubly true of the 
nervous child that if you " spare the rod " you are sure to " spoil 
the child." 

Let me urge parents to secure this self-control and enforce 
this discipline before the child is three or four years of age; 
correct the child at a time when your purpose can be accom- 
plished without leaving in his subconscious mind so many vivid 
memories of these personal and, sometimes, more or less brutal 
physical encounters. Every year you put off winning the dis- 
ciplinary fight with your offspring, you enormously increase the 



THE NERVOUS CHILD 313 

danger and likelihood of alienating his affections and otherwise 
destroying that beautiful and sympathetic relationship which 
should always exist between a child and his parents. In other 
words, the older the child, the less the good you accomplish by 
discipline and the more the personal resentment toward the 
parent is aroused on the part of the child. 

CRIME AND INTEMPERANCE 

While it is generally admitted that feeble-mindedness lies at 
the foundation of most crime, we must also recognize that 
failure on the part of parents to teach their children self-control 
is also responsible for many otherwise fairly normal youths 
falling into crime and intemperance. The parents of a nervous 
child must recognize that they will in all probability be subject 
to special danger along these lines as they grow up. The nerv- 
ous child, as it grows up, is quite likely to be erratic, emotional, 
indecisive, and otherwise easily influenced by his associates and 
environment. 

Nervous children are more highly suggestible than others, and 
if they have not been taught to control their appetites and de- 
sires, their wants and passions, they are going to form an 
especially susceptible class of society from which may be re- 
cruited high-class criminals, dipsomaniacs, and other unfortu- 
nates. 

It is true that any spoiled child, however normal its heredity, 
may turn out bad in these respects if it is not properly trained ; 
but what we are trying to accomplish here is to emphasize to 
parents that the nervous child is doubly prone to go wrong and 
suffer much sorrow in after life if he is not early and effectively 
taught self-control. 

UNSPOILING THE CHILD 

If the child of nervous tendencies forms the habit of crying, 
sulking, or otherwise misbehaving when it is denied its desires, 
or when something it wants done is not immediately attended 
to, it will be found an excellent plan simply to stand still and let 
the little fellow have it out with himself, in the meanwhile 
kindly reminding him to say, " please mamma," " please papa," 



314 THE MOTHER AND HER CHILD 

etc. I well remember one nervous little girl who would yell 
at the top of her voice and become black in the face the moment 
she wanted a door opened or anything else. A few weeks of 
patience and firmness on the part of the mother entirely cured 
her of this unbecoming trait. 

As a rule, it will be found best not to argue with the nervous 
child. The moment your commands are not heeded, when you 
have admonished the child once or twice without effect, take 
him quickly to the crib or the nursery and there leave him alone, 
isolated, until he is in a state of mind to manifest a kindly spirit 
and an obedient disposition. It is an excellent plan quietly and 
quickly to deprive such children of their pleasures temporarily, 
in order to produce thoughtfulness ; and these methods are often 
more efficacious than the infliction of varying degrees of pain 
under the guise of punishment. 

Nervous children must be taught to go to sleep by themselves. 
They are not to be rocked or allowed to hold the hand of the 
mother or the caretaker. The nervous baby should not be en- 
couraged to exhibit its cuteness for the delectation of the family 
or the amusement of strangers and visitors. He should be 
especially trained in early and regular habits, taking particular 
pains to see that bed wetting and similar bad habits are early 
overcome; otherwise, he may drag along through early life and 
become the cause of great embarrassment both to himself and 
his parents. 

The control of these nervous habits is somewhat like the man- 
agement of the slipping of the wheels of a locomotive when the 
track is wet and slippery. The little folks ofttimes endeavor to 
apply the brakes, but they are minus the sand which keeps the 
wheels from slipping. The parent, with his well-planned dis- 
cipline, is able to supply this essential element, and thus the child 
is enabled to gain a sufficient amount of self-control to prevent 
him making a continuous spectacle of himself. 

When nervous children do not walk or talk early, let them 
alone. Of course, if later on it is discovered that they are mani- 
festly backward children, something must be done about it; but 
if the nervous child is encouraged to talk too soon there is great 
danger of his developing into a stutterer or a stammerer. 



THE NERVOUS CHILD 315 

PREVENTING HYSTERIA 

Every year we have pass through our hands men and women, 
especially women, who possess beautiful characters, who have 
noble intellects, and who have high aims and holy ambitions in 
life, but whose careers have been well-nigh ruined, almost shat- 
tered, because of the hysterical tendency which ever accom- 
panies them, and which, just as soon as the stress and strain 
of life reaches a certain degree of intensity, unfailingly pro- 
duces its characteristic breakdown; the patient is seized with 
confusion, is overcome by feeling, indulges in an emotional 
sprawl, is flooded with terrible apprehensions and distracting 
sensations, may even go into a convulsive fit, and, in extreme 
cases, even become unconscious and rigidly stiff. 

Now, in the vast majority of cases, if this nervous patient, 
when a baby, had been thoroughly disciplined and taught proper 
self-control before it was four years of age, it would have 
developed into quite a model little citizen ; and while through- 
out life it would have borne more or less of a hysteria 
stigma, nevertheless it would have possessed a sufficient amount 
of self-control to have gotten along with dignity and success ; 
in fact, the possibilities are so tremendous, the situation 
is so terrible in the case of these nervous babies, that we might 
almost say that, in the majority of such, success and fail- 
ure in life will be largely determined by the early and effective 
application of these methods of preventive discipline. 

I was recently consulted by a patient whose nervous system 
was in a deplorable state, who had lost almost complete mental 
control of herself, and who really presented a pathetic spectacle 
as she told of the fears and worries that enthralled her. In an 
effort to get to the bottom of this patient's heredity I had a 
conference with her father, and I learned that this woman, in 
her childhood days, had been constantly humored — allowed to 
have everything she wanted. She was a delicate and sensitive 
little thing and the parents could not bear to hear her cry, it 
made her sick, it gave her convulsions, it produced sleepless 
nights, it destroyed her appetite, and so she grew up in this 
pampered way. The father recognized the greatness of his mis- 



316 THE MOTHER AND HER CHILD 

take and he told me with tears in his eyes how, when the ring- 
ing of the school bell disturbed his little girl baby, he saw the 
school directors and had them stop ringing the bell, and he even 
stopped the ringing of the church bells. He was an influential 
citizen and could even stop the blowing of the whistles if it dis- 
turbed his precious little daughter. 

And so this woman has grown up with this nervous system 
naturally weakened by heredity and further weakened by " spoil- 
ing " ; and fortunate indeed she will be if off and on the most 
of her life she is not seeking the advice of a physician in her 
efforts to gain that self-control which her parents could have 
so easily put in her possession at the time she was three or four 
years of age, if they had only spent a few hours then, instead 
of the many months and years that subsequently have been de- 
voted to medical attention. 

METHODS OF DISCIPLINE 

We run into many snags when we undertake to discipline the 
nervous baby. The first is that it will sometimes cry so hard 
that it will get black in the face and may even have a convul- 
sion ; occasionally a small blood vessel may be ruptured on some 
part of the body, usually the face. When you see the little one 
approaching this point, turn it over and administer a sound 
spanking and it will instantly catch its breath. This will not 
have to be repeated many times until that particular difficulty 
will be largely under control. 

It will be discovered when you undertake to break a bad 
habit in the case of a spoiled child who is of a nervous tempera- 
ment, that your discipline interferes with the child's appetite and 
nutrition. The delicate little creature who has perhaps already 
given you no end of trouble regarding its feeding, will begin to 
lose in weight, and even the doctor often becomes so alarmed 
that he advises against all further methods of discipline. We 
think this is usually a mistake. Both the nutrition and discipline 
should be kept in mind and carried harmoniously through to a 
successful finish. It will be necessary during such troublous 
times to conserve both the physical and nervous strength of the 
child; it should not be allowed to run about and over-play, as 



THE NERVOUS CHILD 317 

such high strung children often do. It should be given a reason- 
able amount of physical exercise, and two or three times a day 
should have short periods of complete isolation in the nursery, 
where it may quietly play with its blocks and toys, sing and 
croon or talk as the case may be, but should be left entirely 
alone. 

Wise efforts should be put forth to keep the feeding up to the 
proper number of calories, and to see, if the child does not gain 
during this disciplinary struggle, that at least it does not lose; 
and I give it as my experience that I have yet to see a case in 
which both the child's nutrition and discipline cannot be effi- 
ciently maintained at one and the same time, though it does 
sometimes require adroit scientific and artistic management. But 
the game we are playing is worth the effort — the battle must be 
fought — and it can be fought with the least suffering and sor- 
rowing the earlier the conflict is waged to a successful issue. 

I am decidedly opposed to allowing these young nervous chil- 
dren to over-play and thus wear themselves out unduly. This 
over exhaustion sometimes renders the training of the child 
much more difficult, as it is a well-known fact that we are all 
much more irritable and lacking in self-control when we are 
tired, more especially when we are over-tired and fatigued. 

Let me emphasize the importance and value of proper periods 
of isolation — complete rest and partial physical relaxation. 
You can take a child who has gotten up wrong in the morning, 
whose nerves are running away with him, who is irritable, 
crying at everything that happens, who even rejects the food 
prepared for him, and who, when spoken to and commanded to 
stop crying, yells all the louder — I say you can take such a 
little one back to its crib, place it in the bed and smilingly walk- 
out of the room. After a transient outburst of crying, within 
a very few minutes you can return to find a perfect little angel, 
winsome and smiling, happy and satisfied, presenting an entirely 
different picture from the little culprit so recently incarcerated 
as a punishment for his unseemly conduct. 

But let me repeat that while such methods of discipline often 
work like magic on normal children, they must be repeated again 
and again in the case of one who is nervous in order to establish 



318 THE MOTHER AND HER CHILD 

new association groups in the brain and to form new habit 

grooves in his developing nervous system. 

RESPECT FOR AUTHORITY 

There are just two things the nervous child must grow up to 
respect; one is authority and the other is the rights and privi- 
leges of his associates. The nervous child needs early to learn 
to reach a conclusion and to render a decision — to render a 
decision without equivocation — to move forward in obedience 
to that decision without quibbling and without question; that is 
the thing the nervous man and woman must learn in connec- 
tion with the later conquest of their own nerves ; and a founda- 
tion for such a mastery of one's unruly nerves is best laid early 
in life — by teaching the child prompt and unquestioning obedi- 
ence to parental commands. At the same time, endeavor so to 
raise the child that it acquires the faculty of quickly and agree- 
ably adapting itself to its environment, at the same time cheer- 
fully recognizing the rights of its fellows. 

It is a crime against the nervous child to allow it to hesitate, 
to debate, or to falter about any matter that pertains to the 
execution of parental commands. Let your rule be — speak 
once, then spank. Never for a moment countenance anything 
resembling dilatoriness or procrastination, let the child grow up 
to recognize these as its greatest dangers, never to be tolerated 
for one moment. 

FALSE SYMPATHY 

We are aware that many good people in perusing this chapter 
will think that some of the advice here given is both cruel and 
hard hearted ; but we can safely venture the opinion that those 
who have reared many children, at least if they have had some 
nervous little ones, will be able to discern the meaning and sig- 
nificance of most of our suggestions. Sympathy is a beautiful 
and human trait and we want nothing in this chapter in any way 
to interfere with that characteristic sympathy of a parent for 
its offspring — the proverbial " as a father pitieth his children " 
— nevertheless, there is a great deal of sympathy that is utterly 
false, that is of the nature of a disastrous compromise, for the 



THE NERVOUS CHILD 319 

time being making it easy for both parent and child, but making 
things unutterably more difficult later on in life when both 
(or perhaps the child alone) must face the calamitous con- 
sequences of this failure early to inculcate the principles of self- 
control and self-mastery on the mind and character of the 
nervous child. 

We so often hear " mother love " eulogized. It is a wonder- 
ful and self-denying human trait; but, as a physician, I have 
been led to believe that " mother loyalty " is of almost equal or 
even greater value. All mothers love their children more or 
less, but only a few mothers possess that superb loyalty which 
is able to rise above human sympathy and maternal love, which 
qualifies the mother to stand smilingly by the side of the crib 
and watch her little one in a fit of anger — yelling at the top of 
its voice — and yet never touch the child, allow the little fellow 
to come to himself, to wake up to the fact that all his yelling, 
his emotion, his anger, and his resentment are absolutely power- 
less to move his mother. Thus has the mother — by her loyalty 
to the little fellow — taught him a new lesson in self-control, 
and thus has she added one more strong link in the chain of 
character which parent and child are forging day by day, and 
which finally must determine both the child's temporal and 
eternal destiny. 

SYSTEM AND ORDER 

System and order are desirable acquisitions for ail children, 
but they are absolutely indispensable to the successful rearing of 
the nervous child, who should be taught to have a place for 
everything and everything in its place. When he enters the 
house his clothes must not be thoughtlessly thrown about. Every 
garment must be put in its proper place. These little folks must 
be taught a systematic and regular way of doing things. 

Nervous children must not be allowed to procrastinate. They 
must not be allowed to put off until tomorrow anything which 
can be done today. They must be taught how to keep the work- 
ing decks of life clear — caught right up to the minute. They 
should be taught proper methods of analysis — how to go to the 
bottom of things — how to render a decision, execute it, and 



320 THE MOTHER AND HER CHILD 

then move forward quickly to the next task of life. When they 
come home from school with home work to do it would be best, 
as a rule, first to do the school work before engaging in play. 
In fact, all the methods which are needful for the proper dis- 
cipline of the ordinary child are more than doubly needful for 
the training of the nervous child ; while more than fourfold per- 
sistence is needed on the part of parents to make them really 
effective. 

EMOTIONAL RUNAWAYS 

Whether the child be two years of age or ten years of age, 
when the parent discovers that the nervous system is " losing 
its head," that the child is embarking on a nervous runaway, or 
that it is about to indulge in an emotional sprawl, it is best to 
interfere suddenly and spectacularly. Lay a firm hand on him 
and bring things to a sudden stop. Speak to him calmly and 
deliberately, but firmly. Set him on a chair, put him in the bed, 
or take him to a room and isolate him. 

In the case of the older children, tell them a story of the 
horse which becomes frightened, loses self-control, and tears 
off down the highway, wrecking the vehicle and throwing out its 
occupants. Explain to them that many of the mistakes of life 
are made during the times of these emotional runaways, these 
passing spells of lost self-control. Tell the little folks that you 
have perfect confidence in them if they will only take time to stop 
and think before they talk or act. Explain to them that since 
you saw that they were rapidly approaching a foolish climax 
you thought it was your duty to call a halt, to stop them long 
enough to enable them to collect their wits and indulge in some 
sober thinking. 

Personally, we have found it to be a good plan not to be 
too arbitrary with the little folks, like putting them on a chair 
and saying, " You must sit there one hour by the clock." They 
usually begin to indulge in resentful thoughts and a situation 
is often produced akin to that of the stern father who felt 
compelled to go back and thrash his boy three different times 
during his hour on the chair, because of what he was satisfied 
was going through the boy's mind. No, that is not usually the 



THE NERVOUS CHILD 321 

best way. Put them on the chair with an indeterminate sen- 
tence. I prefer to carry it out something like this : " Now, 
son, this will never do; you are running away with yourself. 
Stop for a moment and think. Now I am going to ask you to 
sit clown in that chair there and think this over quietly. I 
will be in the next room. Whenever you think you have got 
control of yourself and have thought this thing out so you can 
talk with me, you may get up from the chair and come into 
the room to me." Sometimes five minutes, sometimes fifteen 
minutes, and the little fellow will walk in and talk to you in 
a very satisfactory manner. He will give you his viewpoint 
and you will be able to adjust the matter in a spirit of con- 
ference which will be satisfactory to both parent and child, 
without doing the least violence to the responsibility of the one 
or the individuality of the other. 

Very little is to be accomplished, when the child starts to 
indulge in an emotional runaway, if the parent contracts the 
same spirit, begins to talk fast and loud, to gesticulate wildly, 
grabs the child, begins to slap and shake it — that is merely an 
exhibition on the part of the parent of the very same weakness 
he is trying to correct in his offspring. I am afraid it is entirely 
too true that for every time you shake one demon out of a 
child in anger, you shake in seven worse devils. When all 
other methods fail and you must resort to punishment, do it 
with kindness, deliberation, and dignity. Never punish a 
child in haste and anger. 

THE FINAL REWARD 

The advice offered in this chapter is not mere theory. It 
has been successfully used by many parents in the manage- 
ment of their nervous children, and while all principles of 
child culture must be carefully wrought out and made applica- 
ble to the particular child in question, nevertheless, the methods 
of repeated and firm discipline herein set forth will enable 
you to take many a child who has been born into this world 
almost neurologically bankrupt, and, by this training and disci- 
pline, enable him in adult life to draw such dividends of self- 
control and self-mastery; as will far exceed the outward results 



322 THE MOTHER AND HER CHILD 

obtained in the case of many children who are born with sound 
nervous systems, but who were early spoiled and allowed to 
grow up without that discipline which is so essential to later 
self-control and dignity of character. 



CHAPTER XXXI 
NERVOUS DISEASES 

IN this chapter we shall consider a number of the more com- 
mon diseases which are associated with the nervous sys- 
tem of the child. Some of these so-called nervous diseases 
are hereditary or congenital, while others are the result of infec- 
tion and environment. 

SLEEPLESSNESS — INSOMNIA 

There are many conditions which cause sleeplessness or 
insomnia in a child aside from disturbance of the mental state 
or nervous system. For instance, late romping, too hearty and 
too late a dinner, lack of outdoor life during the day, illy 
ventilated sleeping rooms, too much bedding, too little bedding 
which causes cold extremities, too much sleep during the day, 
too much excitement (movies or receptions), intestinal indiges- 
tion which is associated with accumulation of gas, and consti- 
pation — any or all of these are causes of sleeplessness. Some 
peculiarly nervous children — those with an hereditary strain 
of nervousness — are easily upset or disturbed by any of the 
conditions above mentioned. 

The treatment of insomnia consists, first, in finding the 
cause and removing it. Children with a nervous tendency 
should be let alone as nearly as possible, and just allowed to 
grow up as the little lambs and calves grow up. They should 
be fed, watered, kept clean and dry, and allowed to live their 
lives undisturbed and without excitement. 

The medicinal remedies on the market for insomnia are all 
harmful if used too long or in excess, and we most earnestly 
urge the mother not to seek drug-store information concerning 
remedies for sleeplessness. The neutral bath is beneficial in 

323 



324 THE MOTHER AND HER CHILD 

ninety per cent of these cases. It is administered as follows: 
Enough water is allowed to run into the bath tub to cover the 
child. The temperature should be 99 to 100 F. It should be 
taken accurately — and should be maintained. Bath tub ther- 
mometers may be purchased at any drug store. The restless 
child, after the bowels have been freely moved, is placed in 
the water, and, without whispering, talking, or laughing, he 
remains there for at least twenty minutes, after which he is 
carefully lifted out, wrapped in a sheet and very gently dried 
off with soothing strokes and placed at once into his night 
clothes. As before said, ninety per cent of restless children 
will go at once to sleep after such a treatment. 

Another method of treating sleeplessness is by the wet-sheet 
pack. Three single woolen blankets are placed on the bed 
and a sheet large enough to wrap the child in is wrung from 
warm water, about 100 F. The child is stripped and this sheet 
is brought in contact with every portion of his body, quickly 
followed by bringing the flannel blankets about him and he is 
allowed to remain there for twenty minutes — if he does not 
fall asleep before the lapse of that time. With witch-hazel 
or alcohol, the body is sponged off, night clothes are put on 
and a restful night usually follows. If fresh air is lacking, open 
the windows. If there is too much bedding, remove some of it. 
Talcum powder the sweaty back and neck and make the child 
perfectly comfortable. Give a small drink of water and turn 
out the light. 

NIGHT TERRORS 

Night terrors are probably due to some digestive disturbance, 
with a coexisting highly nervous temperament. They often- 
times, in older children, follow the reading of thrilling stories 
or a visit to an exciting moving-picture show. The child goes 
to sleep and gets along nicely for two or three hours and then 
suddenly jumps up out of bed and rushes to its mother with 
little or no explanation for the act. In his dreams the thoughts 
and the imaginations of his waking moments are all con- 
founded and alarming. 

We recall one little fellow who constantly feared big, black 



NERVOUS DISEASES 325 

birds coming in the window and attacking him — he had been 
reading about Sinbad the Sailor and his experiences with the 
big bird. He so feared this big, black bird that he could not 
go to sleep. For a number of nights he did not have the cour- 
age to tell his parents that it was the fear of the big bird that 
kept him from going to sleep, but finally he confided in his 
mother and told her of his fear. The mother and father both 
entered into a conversation with him through an open door 
which connected the two rooms, after the lights were out ; they 
laughed and talked about the big bird, they openly talked of it 
and allowed their imagination to work with the child's imagina- 
tion in planning how he could combat with the bird, should it 
really come, asking him how big it really was and what color 
he thought its eyes were and how big an object he thought 
its feet could carry. They all three planned a fairy story they 
might write which would rival the fairy stories of the Arabian 
Nights. In a very short time — possibly a week or ten days — 
the little fellow felt quite equal to these imaginary assaults, 
his fears were quieted and his slumbers were no more disturbed 
by visions of the big, black bird. 

Everything should be done to relieve the stomach and intes- 
tines of laborious work during the sleeping hours, hence let the 
evening meal be light and eaten early enough to be out of the 
way, as far as digestion is concerned, by bed time. 

NERVOUSNESS 

During the formative period of the nervous system — the 
first few years — under no circumstances should the children 
be played with late at night, when they are tired and sleepy, 
or hungry, for it is at such times that the nervous system is 
so easily excited and irritated. When the baby is to be played 
with, if at all, it should be in the morning or after the mid-day 
nap. Rest and peaceful surroundings are of paramount impor- 
tance to the nervous child, and he should be left alone to amuse 
himself several hours each day. It is a deplorable fact that 
the nervous child — the very one that should be left alone — 
is the very child that usually receives the most attention, the 
very one who is most petted, indulged, and pacified; all of 



326 THE MOTHER AND HER CHILD 

which only tends to increase his lack of self-control and to 
multiply the future sorrows of his well-meaning but indulgent 
parents. 

HEADACHE 

Headache attacks old and young alike, and the young infant 
that is unable to tell us he has a headache manifests it by roll- 
ing the head from side to side, putting his hand to his head, 
or by wrinkling up his brow. Headaches may be occasioned by 
disorders of the brain and spinal column, such as meningitis. 
It nearly always accompanies fever, and is often a result of 
constipation, intestinal indigestion, overeating, as well as eating 
the wrong kind of food. 

The treatment of headache in children (aside from removing 
any known cause) consists of a hot foot bath, a brief mustard 
paste to the back of the neck, a light diet — sometimes nothing 
but water — and the administration of a laxative. 

CONVULSIONS — SPASMS 

In the very young, convulsions are easily produced. That 
which will produce but a headache in an adult will often pro- 
duce a convulsion in the child. Aside from diseases of the 
nervous system such as epilepsy, etc., convulsions frequently 
accompany gas on the bowels, intestinal indigestion, disordered 
dentition, an acute illness, intestinal parasites (worms), irrita- 
tion about the genitals such as the need of circumcision, an 
adherent clitoris, adenoids and enlarged tonsils, inflammation 
of the ears, and poor nutrition of any sort such as rickets. 

The convulsion picture is a stiffening of the body — some- 
times arching backwards — rolling or staring of the eye-balls, 
blueness of the skin, a drooling mouth (often foamy mucus at 
the mouth), clinched hands, biting the teeth — if there are 
teeth — and even biting the tongue. There is at first a suc- 
cession of quick, jerking, convulsive movements of the body 
which in a few moments grow less and less violent and finally 
cease. The child begins to cry and then soon goes off into a 
deep sleep, while the body seems more heavy and logy than 
usual. In extreme cases, the child relaxes but for a moment 



NERVOUS DISEASES 327 

of time, when he goes off into another convulsion, sometimes 
going from one fit into another until death relieves him. 

Treatment for convulsions must be instituted at once. Do 
not wait entirely to undress the child — pull off his shoes, place 
him at once into a good warm bath, temperature about 100 
to 102 F. An ice cap should be placed to his head (cracked 
ice done up in a towel), and while in the bath or immediately 
upon taking him out, give a warm soapsuds enema. The bath 
that the child is placed in should be always tested with the 
bared elbow. A half cupful of mustard may be added to the 
bath. Just as soon as the child is able to swallow, give a tea- 
spoon of syrup of ipecac. Enema after enema should be 
given until the water comes back clear. Undue excitement 
after the bath only predisposes to repeated attacks, and while 
the mother may be very happy that the child is himself again, 
under no circumstances should she caress and fondle him. 
Put the little one to bed and allow his nervous system to calm 
down; let him rest quietly and undisturbed. 

NERVOUS TWITCHINGS 

Habit spasms or " tics " are common in childhood, and are 
caused by an over irritability of the nerves supplying certain 
groups of muscles. It is not at all uncommon to see a child 
nervously blink the eyes, twitch the nasal muscles, shrug the 
shoulders, constantly open and close the hand, and execute a 
score of other minor habit-spasms; which, day by day, wear 
deeper and deeper paths into his nervous system as a result 
of their constant repetition. These minor habit-spasms of 
childhood are but telltales of an unstable nervous system, of 
a nervous heredity lacking poise and balance; and, mind you, 
if this nervous system is studied, treated, and properly harnessed 
with self-understanding and self-control, much may be accom- 
plished; the habit may be more or less completely eradicated. If 
left to itself, unchecked, the habit deepens the " spasm-groove," 
and the " energy-leaks " grow bigger and bigger until finally, 
in later, adult life, all that is necessary to convert such per- 
sons into first-class neurasthenics or hysterics is some bad 
news, a few worries, or a sudden shock. 



328 THE MOTHER AND HER CHILD 

By all means study to nip all childhood twitchings in the 
bud ; remembering all the while that childhood — the formative 
period for the nervous system of the child — presents the 
golden opportunity to prevent and abort the more grave neu- 
roses of later life. There may be a special contraction of 
one or more muscles of the eyeball which produces either a 
" cross-eye," when the contraction is convergent, or a turning 
of one eye outward when the contraction is divergent. It is 
not possible for the mother to correct this condition. The 
one important thing for her to do is to take the child to a 
skilled ophthalmologist early in his life, that treatment may be 
instituted for the correction of the difficulty. 

RETENTION OF URINE 

Not an unusual condition during childhood is a temporary 
retention of urine. It may follow an attack of colic or accom- 
pany any acute illness. Increase the water drinking, and, after 
seven or eight hours, hot cloths should be applied over the 
bladder; a large enema (enema bag should be hung low) should 
also be given, retaining as much as is possible. These simple 
measures usually relieve the condition. If retention follows 
circumcision, due to swelling of the parts, the surgeon should 
be notified. 

BED WETTING 

Nocturnal enuresis (bed wetting) usually is found to " run 
in families." It is seldom the case to find that both the father 
and the mother escaped bed wetting during childhood when 
the child is sorely afflicted. 

Early bad habits may be the prime factor in this distressing 
and humiliating difficulty. A little child that has been com- 
pelled to lie in wet diapers for hours at a time gradually 
becomes accustomed to " being wet," and the desire to urinate 
is not under the keen control of a will that has been trained 
by untiring patience to " sit on a chair " at regular intervals 
throughout the day. This lack of training in a child who 
possesses an unstable nervous system, creates the proper 
environment for the habit of bed wetting — which often 



NERVOUS DISEASES 329 

marches steadily on until puberty. In the treatment of bed 
wetting give attention to the following: 

1. The urine should be thoroughly examined. 

2. The size of the bladder should be determined. 

3. The last meal of the day should not be after four o'clock 
in the afternoon. 

4. All during the day, in young children, systematic training 
should be begun — put the child on the chair every hour, then 
every hour and a half, then every two hours. Let the work 
be done most painstakingly and much will be accomplished 
toward training the bladder to " hold its contents " during the 
night. For a time it will be necessary to set an alarm clock 
to ring every three hours during the night, that the bladder may 
be relieved at regular intervals. 

5. No liquids whatever are allowed after four p. m.; even the 
four o'clock meal should be very light. 

6. In older children the habit is often broken by appealing 
to the pride — by requesting or demanding the child to rinse 
out the bed linen and hang it up to dry himself. 

Usually at puberty the trouble ends, and while no amount of 
whipping will correct the difficulty, the promise of rewards, an 
appeal to the pride, correction of dietetic errors, the establish- 
ment of regular times to empty the bladder, the removal of all 
reflex causes such as adenoids, need of circumcision, worms, 
etc. — these combined influences — will bring results in the 
end, if they are faithfully and intelligently applied. 

MENINGITIS 

Cerebro-spinal meningitis is not highly contagious. Children 
old enough to complain of symptoms usually first complain of 
an intense headache with frequent vomiting and very high 
fever. Great prostration is seen, the pulse is weak, the respi- 
rations are irregular, the child may have convulsions, or it may 
have chills and fever, and rigidity of the body may be present. 
The position of the child is very characteristic. It does not 
want to lie on its back but usually rests on one side, with the 
spine more or less arched. It is a very serious disease and 
demands the early attention of a physician. Some cases are 



330 THE MOTHER AND HER CHILD 

very mild and others are exceedingly grave. If the physician 
is secured early, and special remedies administered that are 
known today, many of the children may be saved. 

INFANTILE PARALYSIS 

Infantile paralysis is a serious disease of the spinal cord 
which comes on very suddenly and is associated with vomiting, 
pain in the legs, and a high temperature. After these symptoms 
have lasted a day or two the paralysis is discovered. There 
may be convulsions. The paralysis is progressive, and the 
wasting of the muscles increases until by the end of a couple 
of months one limb is considerably shorter than the other. 
Sometimes the baby goes to bed at night in apparent good 
health and wakes up in the morning paralyzed. 

In this disease the attention of the best physician in your 
community should be called to the case at once, for there are 
being developed in our large research laboratories special vac- 
cines for this condition as well as for spinal meningitis. But 
what is done must be done very, very early, so let there be no 
delay in calling in medical counsel. 

There are other forms of spinal paralysis which, associated 
with tuberculosis of the spine and other spinal diseases, result 
in loss of power to one or more groups of muscles. The only 
treatment that can be given in the home is to keep all of the 
paralytic portions of the body very warm by external heat, 
care being taken to avoid burning, and secure medical advice. 
Often, later in the course of the disease, by the aid of crutches 
and braces, the child can be taught to go to school and to get 
around the house about his little duties. 

The slight facial paralysis which is so often seen in babies 
that have been delivered with forceps, usually clears up in a 
few days or at the latest in a few weeks or months. 

SAINT VITUS' DANCE 

Saint Vitus' dance (chorea) is a peculiar disorder seen in 
nervous children, and which usually clears up in a few weeks 
or months under proper treatment. It is characterized by 
irregular jerkings pretty much all over the body, so that the 



NERVOUS DISEASES 331 

child staggers as he walks, drops his food at the table, and exe- 
cutes many other noticeably abnormal movements. The child 
should be taken out of school at once and removed from 
association with children who might make sport of him or 
otherwise annoy him and thus increase these irregular jerkings. 
He should at once be put under the direction of competent 
medical authority. Simple food, colon hygiene, more or less 
complete rest, and freedom from annoying circumstances, will 
usually bring about a speedy recovery. 

CONGENITAL DISORDERS 

Water on the Brain is characterized by an enlarged head 
due to an increased accumulation of fluid within the cranium. 
While the face remains small the head greatly increases in size 
so that oftentimes it must be braced while the child is com- 
pelled to remain in a wheel chair. The mentality is usually 
fairly normal, but the enormous weight of the head compels 
the life-long occupancy of a wheel chair. 

Deaf-Mutism. The child born deaf pays no attention what- 
ever to sounds. An intellectual expression is seen on his face 
and by six months he is able to do all that a normal baby can 
do with the exception of hearing. The child should early be 
taken to an ear specialist in the endeavor, if possible, to correct 
the defect of hearing. Such little ones who are destined to a 
life without sound, should be given every opportunity to learn 
to read the lips and to secure a good education — to be taught, 
a vocation where eyesight is of more value than hearing. 
Special institutions are in existence today which can take 
these deaf mutes when small and so teach them to make audi- 
ble sounds that they can make themselves understood — at 
least partially. Lip reading is a wonderful improvement over 
the deaf and dumb alphabet, and should be taught early. 

Congenital Blindness. Perhaps not until the child is six 
months old can the observer distinguish between blindness and 
idiocy. The blind child of course will not fix his eyes upon any 
object; but the general lassitude and the inability to hold up 
its head, while seen in idiocy, is not present in blindness. 

Feeble Mindedness. A baby that is born with a weak mind 



332 THE MOTHER AND HER CHILD 

is found to be very backward in all the normal developmental 
attainments of the growing child. A normal baby holds up 
its head at four months and should be able to sit erect at six 
months. The weak-minded baby will not do this, and often as 
late as two years it will not make any attempt to walk or to talk. 
There is an unnatural expression — a vacant look — to the 
face, while there is often much dribbling at the mouth. 

Early Training should be Instituted. It is necessary to call 
the attention of a physician to these facts, that the parents 
may be instructed in regard to the early training which is so 
essential in all these weak-minded little folk. In our opinion 
it is best to remove these children early to special institutions, 
where their education can be superintended by those thoroughly 
accomplished and accustomed to dealing with this class. There 
are varying grades of feeble mindedness — the backward child 
who requires a longer time to learn things, and the child who is 
slow at school and possibly cannot get through more than the 
fourth or fifth grade — but as soon as weak mindedness is 
discovered, it is best to transfer the child to some special insti- 
tution. 



CHAPTER XXXII 

SKIN TROUBLES 

ONE of the earliest skin troubles that the average normal 
child suffers from is prickly heat — a tiny, red-pointed 
rash always accompanied by sweating and usually resulting 
from over-dressing, stuffy rooms, and other conditions that 
make the child too warm. Prickly heat produces more or less 
discomfort but usually little or no itching. Ordinarily, a sponge 
bath followed by the application of talcum powder is sufficient 
to give relief in mild cases; but severe or neglected cases should 
be treated by means of bran baths, a cupful of bran being tied 
up in a gauze bag and suspended in water until the water 
assumes a milky color. Soda baths, two tablespoons to a gallon 
of water, are also very soothing. A baby should never receive 
any friction with a towel after such baths, but should be rolled 
up in a clean linen towel and simply patted dry. 

CHAFING 

Great care should be exercised in the choice of baby's soaps. 
Among a number of soaps that might be mentioned castile soap 
is, perhaps, as good as any. Frequent sponging is required to 
wash off the irritating perspiration ; cool clothing, plenty of tal- 
cum powder, a dose of calcined magnesia, and a regulated 
diet are necessary to clear up the trouble. 

Chafed skin, particularly between the buttocks or in other 
folds and creases, should be kept free from soap. Either the 
starch or bran bath may be tried, while olive oil should be 
frequently and lightly rubbed over the chafed part. A bit of 
sterile cotton placed between the folds to prevent friction is 
often all that is necessary to correct the difficulty. 

Dandruff or milk crust which is often seen on young babies' 

333 



334 THE MOTHER AND HER CHILD 

scalps has been described in detail elsewhere. It should early 
receive the vaseline rub at night which will often loosen up 
the hardened crusts. It may be gently removed in the morn- 
ing with soap and water unless the case has gone on to great 
severity. In such neglected cases the mother should not under- 
take to correct the difficulty alone. Taken early, when the 
scalp is covered with tiny flakes known as milk crust, it can 
be quickly relieved. 

VULVOVAGINITIS 

Vulvovaginitis is a very contagious disease, and before the 
days of hospital asepsis, which is so perfectly maintained today 
in our large institutions, this disease used to go right through a 
children's ward because of carelessness in the handling of soiled 
diapers, etc. The sign of this disease is a yellow-white vaginal 
discharge, while the surrounding skin covering the inside of 
the thighs and buttocks may be very much reddened. The 
baby should be taken at once to the physician at the first appear- 
ance of these symptoms. Only rigid isolation can possibly pre- 
vent other children from getting it — essentials are separate 
towels, wash towels, soap (in the case of the older children), 
and, in the case of the baby, separate diapers and rigid scrub- 
"bing of the attendant's hands — in this way only can this infec- 
tion be held in check. The infected child should sleep by her- 
self, and utmost care must be exercised in preventing her fin- 
gers from first touching the itching vulva and then placing them 
to the eyes or to the mother's eyes. A vulva pad must be worn 
as long as the disease lasts. The physician will give you the 
proper medicines to be used in these cases, and if no physician 
is within reach, you are perfectly safe in dropping into the 
spread apart vulva a few drops of twenty-per-cent argyrol and 
then applying the vulva pad. After each treatment the hands 
of the mother or nurse must be most rigidly cleansed. 

ECZEMA 

Eczema is a very troublesome disease, particularly in infants ; 
there are so many forms of it that there is neither time nor 
space in this volume to describe them individually. This dis- 



SKIN TROUBLES 335 

ease may be produced in children by either internal or 
external causes — from friction on the skin, from coarse, rough 
woolen clothes, or from starched garments, or from lace or 
starched bonnet strings which rub into the folds of the skin. 
Irritating soap, the contact of soiled diapers, cheap toilet pow- 
ders, and discharges from the nose and ears may also be respon- 
sible for the disease. The particular internal causes are over- 
feeding, digestive disturbances, the too early use of starches 
which create fermentation in the intestinal tract. In the most 
frequent form of eczema the skin becomes red and then there 
appear tiny vesicles (water blisters) which soon rupture and 
" weep." This fluid which oozes from these tiny, ruptured 
vesicles, in connection with the perspiration and exfoliation 
of old skin, forms heavy crusts upon the face which are both 
unsightly and annoying. 

Another form of eczema is simply a very badly chafed con- 
dition accompanied by intense itching, and commonly known 
as " dry eczema." A very disagreeable form is the pustular 
variety. One poor little sufferer that was once brought to us 
had so many pustules on his head that one could not put a 
ten cent piece on his scalp without touching a pustule. The 
treatment of these cases, in order to be effective and leave the 
child's head in normal condition, must be administered with 
the utmost patience every day for weeks. A doctor's help is 
always required in combating this sort of skin trouble. If 
the cause is external, then the clothes should be changed. All 
irritation should be removed — the clothing must not be allowed 
to scratch the skin. The child must not scratch himself. If 
necessary, little splints may be placed on the inside of his arms 
to prevent his bending the elbows if the eczema is on the face, 
while the little sleeves may be pinned to the side of the dress 
to resist the movement of the arms. 

ECZEMA TREATMENT 

The diet should be most carefully looked into. The nursing- 
mother will earnestly look into every article of food she her- 
self is eating, and carefully avoid all -foods that produce fer- 
mentation or decomposition. The mother's urine should be 



336 THE MOTHER AND HER CHILD 

examined and its acidity noted; if it is above normal she 
should take some alkalines such as ordinary baking soda or cal- 
cined magnesia. If it is a bottle-fed baby, any form of flour 
should be removed from the food and the quantity of the milk 
reduced. All this, of course, is done under the direction of the 
physician. Repeated doses of castor oil may be given. 

The name of the medicinal agents that have been used in the 
treatment of eczema, is legion. Perhaps one of the most widely 
used is the early varnishing of the affected skin with ichthyol 
(one part ichthyol, one part distilled water), which is swabbed 
on after the skin has been cleansed with olive oil. Allow this 
to almost dry, and then sprinkle on talcum powder which 
smooths over the dry varnish of ichthyol. This is worn every 
night and during the day, in bad cases, even when the eczema 
is on the face. It is renewed each day, and is preceded by 
the olive-oil bath. No water or soap is ever used in eczema. 
Fortunately, the Eskimo has taught us that the skin really can 
be cleansed with oil as well as with water. In the appendix 
will be found two prescriptions, number one and number two, 
that have proved very beneficial in some of the most severe 
forms of eczema. 

HIVES AND FRECKLES 

Hives, a crop of little raised red papules closely resembling 
lesions caused by the sting of a mosquito, may make their 
appearance upon the skin of the child, remain a few hours, and 
then disappear. Hives are usually due to digestive disturbances 
and may be caused by such foods as strawberries, nuts, pas- 
tries, pineapple, certain sea foods, mushrooms, etc. A good 
cathartic, the taking of alkalines, such as baking soda or cal- 
cined magnesia, with a bran or starch bath, or possibly a soda 
bath, will usually correct the difficulty. The same treatment 
may be used in nettle rash or prickly heat. 

Freckles seem to run in families. Broad-brimmed hats or 
sunbonnets may be worn, but under no circumstance should a 
little girl be bidden to remain in the house and shun the beau- 
tiful, sunshiny outdoors just because she freckles easily. Do 
not apply any lotions to the freckled face without medical 



SKIN TROUBLES 337 

advice, for great harm may be done the tender skin of the 
child. 

RINGWORM 

Often upon the scalps of young children may be seen circles 
— rather, patches — which are slightly rough to the touch, and 
which cause the hair to fall out and the spots to remain bald. 
They are known as ringworms of the scalp. The affection may 
likewise appear on the body or the face, presenting a ring of 
reddened skin with a scaly border. Ringworm on the scalp is 
hard to treat and medical help should be secured, for, in spite 
of all that can be done, the disease often runs its course, leav- 
ing round bald spots over the head. Ringworm of the face, taken 
early, is helped by carefully painting with tincture of iodine. The 
mother should constantly bear in mind that ringworm is a 
" catching " disease, so that all handkerchiefs, towels, and 
clothes are to be kept separate. The disease known as mange 
which so often attacks dogs, is nothing more than ringworm, 
and children often contract the disease from dogs. Ringworm, 
whether it be on children or dogs, may be greatly helped by 
the use of tincture of iodine and other appropriate remedies. 

BOILS 

The much poulticing of boils has done an untold amount of 
mischief. Many children and adults are in their graves today 
because of improper treatment of boils. Blood poisoning which 
so often follows the careless poulticing, as well as the uncleanly 
opening of boils, can all be avoided. Before touching a boil, 
the surrounding skin should be thoroughly washed with sterile 
cotton and laundry soap and then disinfected with alcohol. 
Then, with a scalpel or a surgeon's knife which has been either 
boiled for twenty minutes or allowed to remain in pure car- 
bolic acid two minutes and then in alcohol two minutes, it should 
be thoroughly opened down to the core so that the pus may 
come out. It is very much better for the trained hands of a 
physician to do this than for any member of the family to 
undertake such an operation — where the danger of blood poi- 
soning is always present. The only treatment of skin eruptions 



338 THE MOTHER AND HER CHILD 

containing pus which is justifiable for the home folks to under- 
take is to simply paint them with iodine. Under no circum- 
stance should poultices be used. 

FEVER BLISTERS 

It is not at all uncommon for small children to develop a 
group of fever blisters on the lips when suffering with any 
disease, or experiencing a high fever. Even a simple cold or 
a spell of indigestion may be accompanied by fever blisters. 
They appear not only on the lips but also on the edges of the 
nose and may even be seen on the chin. 

Early in their first appearance they may be treated with 
spirits of camphor or plain alcohol, which sometimes tends to 
abort them; but they usually run their course, and when they 
are fully developed they may be treated with zinc oxide, sim- 
ple borated vaseline, or ichthyol. 

WARTS 

Very often children's hands are disfigured by warts. They 
appear suddenly, develop rapidly, and many times disappear 
just about as suddenly as they appeared. Every child suffer- 
ing from warts usually passes through the stage of charms 
and lingoes which are popularly used to remove these disagree- 
able growths. We hardly see any efficacy in " bean-ie, bean-ie 
take this wart away," or any particular virtue in stealing 
mother's dishcloth, cutting it up into as many pieces as there 
are warts on the hand and rubbing each wart with a separate 
piece of the cloth; but you will find people in every town or 
village who will assure you that their warts were driven away 
by one of these charms or lingoes. Warts are either better 
left alone or removed by a physician with the high-frequency 
spark or some other reliable method. 

BIRTHMARKS 

A red or purplish patch on the skin is the result, as men- 
tioned in an earlier chapter, of an embryological accident in 
which one or more embryonic cells slipped out of place in the 
early days of skin formation. These accidental markings may 



SKIN TROUBLES 339 

occur on the face, the scalp, or on any other portion of the 
body, and they should be let alone, unless they show a tendency 
to grow, when it may prove best to give them proper surgical 
attention. 

A mole is also a birthmark, and if found upon the neck or 
shoulders where it is likely to disfigure, it may be removed by 
the high-frequency spark, or by surgery, in the same way as 
warts. Never tamper with moles. Leave them alone or turn 
them over to the surgeon. 

ERYSIPELAS 

Erysipelas is a much-dreaded disease which is the result of 
infection with the blood-poisoning germ — streptococcus. It 
usually occurs about a wound, and is due to infection by this 
microbe. If it follows circumcision, it is due, of course, to 
infection, and may be very serious, even causing death. It 
attacks persons of any age and is oftenest seen on the face. In 
appearance, the skin is a bright and shiny red, with a definite 
line of demarcation slightly raised at the edges because of the 
swollen tissues underneath. On pressure, the redness disap- 
pears but reappears immediately upon relieving the pressure. 
The inflammation, pain, and fever often continues a number of 
days, during which the child should be isolated from all other 
members of the family. The bowels should be freely opened, 
and the diet should be liquid and soft; while local treatment is 
cared for by the physician who should always be called. Should 
erysipelas develop on a very young baby it is very important 
that he should be removed at once from the mother. As stated 
before, the disease is produced by the blood-poisoning germ 
which is very much to be avoided in any and all stages of 
obstetrics. One attack in no way renders the patients immune. 
They may have repeated attacks of erysipelas. The treatments 
should be started early and kept up most rigidly. 

SCABIES AND LICE 

In thickly settled districts among the poor and uneducated, 
where filth and untidiness reign, the " itch " is a very promi- 
nent disease. It is caused by the itch mite, a parasite which 



340 THE MOTHER AND HER CHILD 

burrows underneath the skin leaving behind its eggs in little 
irregularly shaped, bluish tinted ridges. Such a profound 
itching is set up by this burrowing and depositing of eggs that 
the child cannot resist scratching, and all taken together pro- 
duces the typical itch-rash. The common site for this rash is 
on the sides and between the fingers and toes ; on arm pits and 
buttocks of the child, as well as at the waistline. The treat- 
ment is usually beyond home remedies. A physician should 
have charge of the case who will conduct a line of treatment 
which, if diligently followed, will rid the body of this scourge 
within a week or ten days. 

Along with the itch are often found parasites of the head, 
or lice (pediculi). It is not at all infrequent to find them in 
the heads of uncared for children; but if a much-cared- for 
child is brought in contact with an infected head he will prob- 
ably " catch " the infection. A most intense and disagreeable 
itching is set up at once. The treatment consists in getting 
the head clean by the use of a very fine comb, thus endeavor- 
ing to remove the adult parasites as well as the eggs or " nits." 
However, great care should be taken to avoid injuring the 
scalp. Perhaps the simplest and most effective treatment 
known is the kerosene bath which should be applied at night, 
the hair being done up in a bandage until morning, when the 
kerosene is washed off with soap and water and then the hair 
given a vigorous vinegar shampoo in order to destroy the 
" nits." Tincture of larkspur, or an ointment made from the 
seeds, may also be used. It is applied several days in succes- 
sion and then washed out. 



CHAPTER XXXIII 
DEFORMITIES AND CHRONIC DISORDERS 

REFERENCE has already been made to certain accidents 
of embryology during the very early days or weeks of the 
formative period of the embryo. Common illustrations of such 
deforming developmental accidents are harelip, cleft palate, 
and club foot. 

HARELIP AND CLEFT PALATE 

In the case of a partial or complete failure of the two sides 
of the face to come together in the median line, a deformity 
results which is known as harelip — a partial or complete cleft 
of the upper lip. It may be a single or a double cleft, expos- 
ing the teeth, or the cleft may even extend up into the nose. 
This deformity may seriously interfere with nursing, making 
it necessary to resort to feeding with a medicine dropper and 
later a spoon. The success of the operation for the relief of 
harelip, which should usually be performed during the early 
months of life, is often very remarkable. 

Should this failure to unite be in the deeper structures of 
the head, then cleft palate is the result. This, too, may be par- 
tial or complete: partial as seen in a cleft of the soft palate 
only; and complete, when the hard palate also is involved. In 
such an instance it is the floor of the nose that is defective; 
hence the nose and mouth are one cavity. 

A specially devised apparatus which assists the child in nurs- 
ing may be found on the market, for nursing is well-nigh 
impossible without the closure of the roof of the mouth. The 
operation for cleft palate is usually successful when performed 
at the proper time and by competent hands. 

In tongue-tie the weblike membrane underneath is attached 

341 



342 THE MOTHER AND HER CHILD 

too far forward, so that the child is quite unable to protrude 
his tongue, and this condition greatly interferes with sucking. 
The operation for the relief of this condition is slight, and 
should be performed as soon as the defect is discovered. 

DEFORMED HANDS AND FEET 

Occasionally there is a webbing of one or more fingers of the 
hand, and there are sometimes seen too many fingers or a dou- 
ble thumb. It is needless to allow such a deformity to continue ; 
the operation for relief is often remarkably successful and 
should be performed very early. 

Clubfoot results when short tendons or contracted tendons 
pull the toes inward or outward with raising of the heel. Treat- 
ment must be instituted early; braces or splints are applied; 
and untiring efforts are put forth in massage and other lines to 
prevent a lifelong handicap of clubfoot. 

An inward rotating of the legs presents the deformity of 
pigeon-toe. The normal foot naturally inclines toward " point- 
ing in," and such a condition should not be discouraged. Many 
flat feet (broken arch) are due to shoe lasts which compel 
the toes to slant " out," and the bunions which so often follow 
such mistreatment may be exceedingly painful. 

By all means place shoes on the pigeon-toed child that pos- 
sess straight lasts with flexible arches, and which admit of the 
exercise of many muscles of the foot which otherwise remain 
inactive. 

As the child grows older the toenails thicken, and often in 
their trimming they are cut so closely at the corners that some- 
times a condition results known as ingrowing nails. Such are 
very painful and must receive special attention. First of all, 
the nail is cut squarely, and after scraping it thin the corner 
is lifted and cotton so placed under it that the nail's downward 
and inward growth is stopped. 

SPINAL CURVATURE 

Curvature of the spine is more common than is usually 
thought. The most frequent variety of it is the lateral 
curvature. One shoulder is lower than the other, and the hips 



DEFORMITIES AND CHRONIC DISORDERS 343 

are therefore uneven. Rickets, during infancy, is the most 
common cause of spinal curvature. 

Improper sitting at school — sitting on the edge of the seat 
— or carrying heavy loads are often contributing factors to the 
production of lateral curvatures. Only the muscles and liga- 
ments enter into this deformity, hence the treatment should 
be started early and should consist of: 

1. Stretching exercises. 

2. Hanging from the rounds of a ladder securely fastened to 
the wall. 

3. Certain applications of hot fomentations to the spinal mus- 
cles for their relaxation. 

4. Firm cushion placed under one or other of the hips to 
encourage the re-establishment of muscular poise. 

5. Special supervision of the case. 

pott's disease 

Pott's disease, or tuberculosis of the bone, often results in 
an angular spinal deformity. This curvature, unlike the lateral 
curvature, is a sequela of an actual disease of the bones. It is 
always very serious and demands early treatment from skilled 
hands. Early in the disease there is a peculiar stiff, tottering 
gait. The little child holds the spine rigidly, and in picking up 
objects from the floor bends the knees instead of the spine. If 
the trouble is in the upper spine, the shoulders are held high 
and the head is stiffly poised, it is never rotated; in looking 
about the entire body turns. 

Medical aid should be secured early. The X ray not only 
locates the difficulty but also determines the extent of the 
process. If the spine be put to perfect rest, outdoor life begun, 
a diet rich in fats established, the results are often wonder- 
fully successful. 

Another tubercular condition is seen in the much dreaded 
hip-joint disease which parents should always be on the look- 
out for. The earliest symptoms are crying out in the night 
suddenly, unnatural standing on one leg (to relieve the strain 
on the diseased hip) and so-called " growing pains." Call in 
a physician very early and institute proper treatment. A pos- 



344 THE MOTHER AND HER CHILD 

terior curvature of the spine is often associated with a bad 
case of rickets. It is of temporary duration, and usually clears 
up when the symptoms of rickets have been eradicated. It 
involves only the back muscles — not the vertebral bones, 

The young mother is often very much concerned over the 
misshapen head of the child as a result of a prolonged labor; 
and it does seem quite miraculous to see a head, more nearly 
resembling an egg than anything else, become beautifully 
round and shapely by the end of two or three days. 

Protruding ears may be encouraged to lie more flatly by the 
wearing of a specialized bonnet at night. When the babies are 
too young to turn themselves they should be turned first to one 
side and then the other, while care should always be exercised 
in properly straightening out a curled under ear or an over- 
lapping ear. 

RHEUMATISM 

While we so often regard rheumatism an adult disease, never- 
theless, children do suffer its aches and pains as well as the 
fever which so often attends the inflammatory type. The so- 
called " growing pains " are often of rheumatic origin. 

Diseased tonsils not only are often — very often — the ave- 
nue of entry of infectious microorganisms that cause one type 
of rheumatism, but many forms of valvular heart disease are 
also directly traceable to these same diseased tonsils. The 
treatment consists in giving proper attention to the tonsils, 
even removal if necessary — and if the child is old enough. All 
other possible causes should be located and removed; the child 
should have absolute rest in bed with brisk cathartics and a 
liquid diet (no meat broths). The diet should consist more 
of alkalinizing foods as shown in the special table in the appen- 
dix. Medicinal alkalines are often given when the urine shows 
a very high acid reaction. 

SCURVY 

Scurvy, seen in children who subsist on " prepared foods," 
is manifested by tender legs and swollen gums which have a 
tendency to bleed easily. Pallor, loss of appetite, and insomnia 



DEFORMITIES AND CHRONIC DISORDERS 345 

accompany the condition. The treatment of scurvy is change 
of diet from " patent foods " to fresh cow's milk, with the 
addition of orange juice, daily. In older children the food must 
be very nutritious; out of door life, salt glows, friction baths 
(see appendix), and the taking of large amounts of fats are 
all essential to the cure. 

ADENITIS — ENLARGED GLANDS 

Enlarged glands, or what our grandmothers used to call 
" kernels " in the throat are often the result of inflammation in 
the mouth or throat, and occur in connection with many of 
the childhood diseases, notably diphtheria, scarlet fever, and 
scarlatina. 

Glands appearing in the back of the neck may be occasioned 
by pediculli (lice), ring worm, or eczema, while those seen in 
the neck just back and below the ears may come from mas- 
toiditis (inflammation of the middle ear) or adenoids. 

Glands felt under the arm enlarge because of trouble or 
infection in the breast, hand, or arm ; while glands in the groin 
are usually due to some infection of the feet, legs, or abdomen. 

These glands usually disappear when the general health and 
well-being of the child is improved by: 

i. Outdoor life. 

2. Morning dry-friction rub to the skin. 

3. Good liberal diet, including plenty of fats. 

4. No feeding between meals. 

5. The salt glow and general tonic treatment (see appendix). 

6. The oil rub at night. 

RICKETS 

Rickets (a disease of the bones) often follows in the wake 
of faulty feeding and unhygienic surroundings. The bones 
lack a proper amount of lime salts and other elements. Devel- 
opment in general, especially that of the bones, is greatly inter- 
fered with. 

Bowlegs, prominent square brow, enlarged perspiring head, 
weakness, and often tenderness of the flesh, are notable 
signs of the disease. The treatment varies little from that 



346 THE MOTHER AND HER CHILD 

of scurvy, and will be provided in detail by the attending 

physician. 

MALARIA 

Children often suffer from malarial parasites. Sudden rise 
of fever on regular days (sometimes daily, every two days or 
every three days) should demand a careful medical examina- 
tion including the examination of the blood where the offend- 
ing organism is seen in the red blood cells. We recently saw 
a little girl who happened to have an earache and was about 
to be operated on for ear trouble, when examination of the 
blood revealed the fact that she was suffering from malaria. 

TUBERCULOSIS 

In the routine examination of adult patients, the X ray 
observations of the lungs often reveal deposits of lime salts 
which tell the story of a successful fight against tuberculosis 
(Fig. 16). And while it may seem surprising, we believe 
beyond a doubt that most of us have had some varying degree 
of tuberculosis while young — the unrecognized battle has 
been fought — and these small monuments of lime salts alone 
remain to tell the interesting story. 

The pity of it is that whole armies of little folks fall in this 
struggle against disease, for it is one of the common and fatal 
diseases of childhood. Fresh-air schools, playgrounds, and 
free school lunches are saving hundreds of children from 
the ravages of this disease each year. 

Tuberculosis is strictly a house disease, hence the little 
tubercular patient must seek outdoor life. All avoidable expo- 
sure to the disease must be denounced, and public sentiment 
must continue to be aroused to the hygienic betterment of the 
tenement districts and basement homes. The sanitary drinking 
cup and the bubble fountain must be encouraged, as must also 
the proper ventilation of all places where crowds assemble, be 
it the schoolroom, the theater, or the church. 

SYPHILIS 

While tuberculosis is known as the " great white plague," 
syphilis and gonorrhea constitute the " great black plague," 




Fig. 16. X ray Showing Tuberculosis of the Lung 



DEFORMITIES AND CHRONIC DISORDERS 347 

which seen in the little folks is pitiable indeed, leading us to 
realize that surely " the children's teeth have been set on 
edge " because of the careless eating of sour grapes by the 
parents. Syphilitic parents who have not been properly treated, 
should think many times before they take upon themselves the 
awful responsibility of bringing into the world a tainted child. 
Proper mercurial treatment should be instituted at once not 
only for the child but also in the case of both parents. 



CHAPTER XXXIV 
ACCIDENTS AND EMERGENCIES 

IN this chapter we wish to instruct the mother or the care- 
taker in doing the one thing needful for every one of the 
more common household accidents and emergencies while wait- 
ing for the doctor. 

In every household there should be found an accident and 
emergency " kit " of necessary paraphernalia for the quick 
application of the one necessary medicine, dressing, etc. This 
" kit " should contain baking soda for burns, bandages and 
sterile gauze for cuts or tears, together with adhesive plaster, 
needle and thread, etc. 

INSECT BITES AND STINGS 

Far greater harm is often done the skin by the subsequent 
scratching of the insect bite with dirty finger nails than by the 
bite iself; and so it is very important that we remember to 
allay quickly the intense itching by the application of ammonia 
water or camphor. Almost instantly the itching is stopped, 
and the added " scratching " irritation to the already injured 
skin is thus avoided. 

By the aid of a magnifying glass, and often by the naked 
eye, we may detect the stinger which has been left behind by 
the greedy guest, and which should be removed by a pair of 
tweezers. Ice-water compresses will stop the swelling and even 
an old-fashioned mud dressing, which was used and appreci- 
ated by our great grandmothers, is a thing not to be despised. 

If the much admired shrubbery be removed one hundred feet 
away from the porch, mosquitoes would trouble the household 
less. It has been demonstrated in many localities that clearing 
away the near-by clumps of shrubbery permits the family to 

348 



ACCIDENTS AND EMERGENCIES 349 

sit on unscreened porches unharmed. Mosquitoes multiply 
rapidly in stagnant pools of water, but if oil is poured over 
these stagnant waters the increase of mosquitoes is abated, and 
their total extinction is not unheard of in swampy districts 
receiving such care. 

Whenever baby is out of doors where mosquitoes, flies, or 
other insects are to be found, he should be properly protected 
from such pests by mosquito netting stretched over a frame 
eighteen inches above his face, for we can think of nothing 
more uncomfortable than a mosquito netting dragging over a 
sweaty baby's face. The fact that mosquitoes, flies, roaches, 
and other insects are carriers of tuberculosis, infantile paraly- 
sis, typhoid fever, cholera, yellow fever and malaria, as well 
as a host of minor ailments, should make us the more anxious 
for either their extermination or the protection of our chil- 
dren from their greedy bites and stings. 

DOG BITES AND SNAKE BITES 

Dogs, cats, rats, or mice bite at any time of the year, and 
provision should always be made for ample protection against 
such accidents. 

Such a wound should always be squeezed or sucked until it 
has bled freely, and then be cauterized by a red-hot iron or 
touched with an applicator that has been dipped in sulphuric 
acid or nitric acid. A subsequent dressing of Balsam Peru is 
healing. The dog should be watched, and if it shows signs of 
hydrophobia the bitten child should be promptly taken to the 
nearest Pasteur Institute for treatment. 

In the case of snake bites the same sucking and cauterizing 
treatment is indicated, with the additional tying of a hand- 
kerchief or cord a few inches above the wound to stay the prog- 
ress of the blood and to keep the poison out of the general 
circulation. A solution of twenty-per-cent permanganate of 
potash should be used to wash the wound. 

The popular administration of large draughts of whiskey is 
of no benefit, for the secondary depressant effect of alcohol 
increases the body's poison burden, and those who survive do 
so in spite of the whiskey, and not because of it. 



350 THE MOTHER AND HER CHILD 

SWALLOWING FOREIGN BODIES 

Small articles such as buttons, safety pins, thimbles, coins, 
etc., are often swallowed by little folks, and if they lodge in 
the throat and the child struggles for his breath the treatment 
is as follows: grasp him by the heels and turn him upside 
down while a helper briskly slaps him on the back. The for- 
eign body generally flies across the room. If it is lodged high 
up in the throat it may often be dislodged by the thumb and 
finger. If it cannot be reached and it will not go down, lose 
no time in seeking an X-ray laboratory where its exact loca- 
tion may quickly be discovered and proper measures instituted 
for its removal. 

A troublesome fish bone is easily dislodged by swallowing 
a half-chewed piece of bread which carries it down to the 
stomach. Cathartics and purgatives are not to be given; in due 
time the object will appear in the stool. In all instances it is well 
to locate its exact position by the X ray — that there may be 
assurance that it will do no harm. 

It is surprising what large objects can be swallowed. One 
old gentleman swallowed his false teeth, and a six months old 
baby swallowed, or at least had lodged in its throat, a silver 
dollar. 

All detachable parts should be removed from toys that are 
given to babies, such as the whistle from rubber animals, the 
button eyes of wool kittens and dogs, and other such remova- 
ble parts. 

FOREIGN BODIES IN THE EYE 

To begin with, do not get " panicky," but carefully, pains- 
takingly, and patiently do the following: 

1. Rub the well eye until the tears flow plentifully in both 
eyes. 

2. Blow the nose on the injured eye side, closing the other 
side. This often encourages the tears to wash the foreign 
speck down through the tear duct, into the nose and out into 
the handkerchief (in case the child is old enough to follow such 
instruction). If the foreign body be sharp, as a piece of steel 
or flint is likely to be, it may be driven right into the eyeball. 



ACCIDENTS AND EMERGENCIES 351 

Seek a physician who will drop medicine into the eye to deaden 
the pain and then if it cannot be gently rubbed off the eyeball, 
a magnet will promptly remove it. 

An eye bath of warm boracic acid is always comforting 
and never does harm, so that may be given while waiting for 
the doctor to come, if the object seems to be beyond the reach 
of family help. 

If an alkaline, such as lime, be blown into the eye it is very 
painful, but much relief may be obtained by gently pouring 
into the eye, by means of a medicine dropper or eye cup, warm 
water to which has been added a little vinegar or lemon juice. 
Likewise, acid in the eye produces much pain. In this instance, 
an eye bath of a weak soda solution is indicated. 

FOREIGN BODIES IN EAR AND NOSE 

Insects that have crawled into the ear may be suffocated by 
dropping sweet oil or castor oil into the ear, which, after twenty 
minutes, should be washed out by gentle syringing with warm 
water from a fountain syringe, hung one foot above the child's 
head. 

Peas, beans, shoe buttons, or beads are sometimes put into 
the ear and nose by adventurous or experimenting children. 

The shoe button or bead will not swell as does the pea or the 
bean, and may often be safely washed out. If it is causing 
no pain and will not drop out in case of the ear, or will not be 
easily blown out in case of the nose, see your physician at once. 
He has in his possession just the necessary instruments for 
its immediate removal. 

Peas and beans swell, and consequently cause greater dis- 
comfort the longer they are in; do not poke at any foreign 
body lodged either in the nose or the ear, for the ear drum may 
thus be injured, while in the former case it may be pushed 
into one of the accessory sinuses. 

EARACHE 

One of the most comforting and highly effectual forms of 
heat for an aching ear is a four-candle-power carbon electric 
light on an extension cord that permits the light to come in dose 



352 THE MOTHER AND HER CHILD 

contact with the ear. A shade is made from a piece of stiff 
letter paper that fits the socket snugly and flares out to a three 
inch opening, which should extend below the point of the bulb 
one inch. This shade holds all the heat and light and directs it 
into the aching ear. 

In every well-ordered household there will be found a 
three-per-cent solution of carbolic acid and glycerine of 
which one drop should be put into the aching ear, and then the 
external heat, mentioned above, should be applied. A bag of 
warm salt, a hot water bag, or a warm plate will provide exter- 
nal heat if an electric light is not available. Do not put lauda- 
num or other remedies into the ear, other than are herein sug- 
gested, without your physician's knowledge. 

Earache is always serious, and since it is usually indicative 
of trouble which, if left untreated, may cause deafness, it 
demands thorough treatment from skilled hands. 

Running ears invariably need medical attention and should 
never be neglected. 

NOSEBLEED 

If the nose bleeds whenever it is cleansed, more than likely 
there is an ulcer on the septum which will continue to bleed if 
left untreated. The physician should heal the ulcer, and the 
child should be taught always to vaseline the nostril before 
cleansing it. 

In case of persistent nosebleed, put the child to bed with the 
head elevated. Pressure should be put on the blood vessels 
going to the nose by placing two fingers firmly on the outer 
angles of the nose on the upper lip, while a helper may put 
firm pressure at the root of the nose at the inner angle of each 
eye. An ice bag may be placed at the back of the neck, and 
another piece of ice held on the forehead at the root of the 
nose. If these measures do not stop the flow of blood a few 
drops of adrenalin may be put into the nose and repeated in 
five minutes if necessary. As the bleeding begins to stop, as 
well as during the bleeding, all blowing of the nose is forbid- 
den as it will only cause the bleeding to start afresh. It some- 
times helps to hold a piece of ice in the hands. 



ACCIDENTS AND EMERGENCIES 353 

CUTS AND TEARS 

A cut with smooth edges, if deep, should be allowed to bleed 
freely, should be washed in boracic acid solution, and its edges 
held together by a stitch which is usually put in by a physician ; 
but if treatment is to be given at home, the hands of the nurse 
must be thoroughly washed and the thread and needle boiled 
for twenty minutes. If the physician has been sent for, make 
firm pressure over the wound by bandaging tightly with a 
dressing of sterile gauze dipped in boracic acid solution. 

In case of a slight cut, make it bleed freely, then wash in 
boracic-acid solution and apply sterile gauze held in place by 
a binder. If no odor or pain follows, let alone for two or 
three days, when a new dressing is applied. 

A physician should be called in case of ragged wounds or 
tears, as such usually leave bad scars. Cleanse carefully, leav- 
ing no dirt in the wound, cause it to bleed, if possible, and apply 
a sterile gauze compress wet in boracic-acid solution, bandaged 
on as directed above. Zinc ointment may be applied to sur- 
faces that have been skinned. All dressings on dirty wounds 
should be changed daily. 

Blood poisoning may readily follow a wound, hence the utmost 
cleanliness should prevail. The hands of the attendant, the 
dressings, the surrounding skin, must all be clean. The bowels 
should be kept open, and under-feeding rather than over-feed- 
ing is indicated. 

If a needle be needed to open a sore or boil, always disinfect 
the part and surrounding area by painting with tincture of 
iodine, and heat the needle to red heat through a flame before 
it touches the sore. 

In case of cuts or wounds of the eyeball apply a compress 
of sterile gauze wet in boracic acid, held on by a bandage, and 
go immediately to a good eye specialist. 

PUNCTURED WOUNDS AND SLIVERS 

Wounds made by pins, needles, fishhooks, tacks, and splinters 
are always very painful and great care must be exercised to 
force bleeding freely, which helps to wash out infection, as 



354 THE MOTHER AND HER CHILD 

more than likely microbes entered with the instrument or 
sliver when the wound was made. 

Fishhooks are exceedingly troublesome, as they often occa- 
sion the enlarging of the wound to get them out, especially if 
they have gone in beyond the barb. 

Slivers are easily broken off, so great care is needed in their 
removal. A pair of tweezers is convenient for seizing the 
protruding portion, while all side movements are avoided lest 
it break off in the flesh, in which case it may be gotten out 
with a needle that has been sterilized in a flame. 

All puncture wounds should be dressed with the wet, sterile 
compress, covered over with wax paper and bandaged loosely; 
this encourages cleanliness and favors healing. 

BRUISES 

If left untreated, bruises swell, become highly discolored, 
and in the process of healing pass through the dark blue, green, 
and yellow stages. The treatment is as follows : Apply hot and 
cold alternately — the heat should be as hot as can be borne 
and left on very hot for three minutes, then ice water com- 
presses should be applied for one minute, then hot again — these 
changes should continue for an hour, and if carried out imme- 
diately after the injury all discolorations and most of the swell- 
ing may be avoided. Witch-hazel compresses are comforting. 
If discoloration has taken place, the application of hot com- 
presses will often hasten its disappearance. 

FRACTURES AND DISLOCATIONS 

While there is very little a member of the family or a non- 
medical friend can do in case of a fracture, and while it is 
unwise to offer suggestions relative to the setting of bones, yet 
it is highly important that both the family and friends know 
how properly to support a broken leg while carrying a disabled 
person into the house or to near-by medical aid. 

For instance, in the case of a fractured leg below the knee, 
if a couple of flat boards three inches wide be tied about the 
leg with two pocket handkerchiefs, the ends of the fractured 
bone will not rub against each other and the pain will be 



ACCIDENTS AND EMERGENCIES 355 

much less in carrying. In this way all danger of causing the 
broken bones to protrude and thus " compounding " the fracture 
is also avoided. And also, if there is no near-by ambulance, 
a good emergency stretcher may be improvised out of two or 
three buttoned vests with two poles, rakes, or brooms run 
through the armholes — one vest under the shoulders and one 
under the hips and still another under the fracture. An injured 
person may in this way be carried for miles quite comfortably. 

Two people may fashion a seat out of their four hands on 
which the disabled child may sit with his arms about the necks 
of his two friends. If the fractured end of the bone penetrates 
the flesh it is then known as a compound fracture and the 
utmost cleanliness must prevail — as in dressing other wounds. 
An X ray laboratory should always be sought, where con- 
venient, to ascertain if the ends of the bones are in good 
position. 

In dislocations, the bone has slipped out of place at the joint. 
Medical aid should be called to replace the bone, while hot 
applications may be used in the meantime. 

SPRAINS 

All sprains (a twist or straining of a joint) should promptly 
be put into a very hot bath and held there for thirty minutes. 
If this is impossible, then a rubber tube or a handkerchief is 
tied snugly between the sprain and the trunk of the body. Almost 
instantly the pain, which is often intense and severe, is very much 
lessened. The hot-water bath is very hot, and the joint should be 
very red on taking it out. Immediately following the bath the 
injured joint is wrapped in a very cold wet compress, which 
is next completely covered by silk, gutta-percha, mackintosh, 
or many thicknesses of newspaper — anything that will hold 
all the heat in — as the cold compress is quickly heated up. 
Lastly, a bandage of heavy flannel completely covers the whole 
— compress, impervious covering, etc. 

The joint is now elevated for three hours, when it is again 
immersed in a very hot bath and then again the cold compress 
is applied. This is continued every three hours, except during 
sleep, for two days, after which it may be done morning and 



356 THE MOTHER AND HER CHILD 

evening. Massage is now administered every three hours, first 
four inches below the injury then four inches above it, while 
in a day or so the joint itself may be gently rubbed with well- 
oiled hands. By the end of one week the patient begins to use 
the injured member. 

In the case of a sprained ankle a properly applied adhesive 
strap bandage will give no end of relief and support. Various 
liniments may be applied, but usually the good obtained is from 
the thorough rubbing which always accompanies their use 
according to directions. 

Sprains treated as above directed will often liberate the 
child in one-third the usual time generally allotted for its 
healing. 

FROST BITES AND CHILBLAINS 

Keep the child who has frozen some part of his body in a 
cool room, and rub the frost-bitten part with snow or ice water, 
or wrap it up in cold water compresses. 

The return to heat must be slow indeed, else much pain may 
be experienced; blisters followed by discoloration, and even 
mortification, may set in. You may be surprised some morning 
on awakening to find your child's hand twice its normal size 
and very red, because it was out from under the cover a good 
share of the night exposed to Jack Frost. Do not bring it to 
heat quickly but immerse it in cold water, gradually and slowly 
raising the temperature of the bath until it is warm and com- 
fortable. 

The intense itching and burning of a chilblain may often be 
relieved by painting with iodine or triple chloride of iron (Mon- 
sel's solution). Soap liniment has also been suggested, as 
well as alternate applications of hot and cold water. Chilblains 
are troublesome, painful, and their yearly recurrence is often 
very annoying. 

SWALLOWING POISONS 

Poisons of an acid nature, such as hydrochloric, sulphuric, 
nitric, or oxalic acids, are neutralized by alkalines, such as 
magnesia, chalk, soda, and soap, followed by soothing drinks 
or sweet oil. 



ACCIDENTS AND EMERGENCIES 357 

Remember that carbolic acid is not an acid, and is not anti- 
doted with alkalines. The swallowing of carbolic acid should 
be quickly followed by diluted alcohol, and if this drug is not 
ready at hand many of the numerous alcoholic patent medicines 
will do just as well. Epsom salts should be given in abundance. 

Poisons of an alkaline nature, such as lye, washing soda, 
ammonia, etc., are antidoted with vinegar or lemon juice, fol- 
lowed by soothing drinks or sweet oil. 

A complete table of poisons and their antidotes will be found 
in the appendix. 

Poison ivy, as soon as detected, should be treated as follows : 
Thoroughly scrub the affected part with tincture of green 
soap and hot water, which often prevents the trouble develop- 
ing. Clean pieces of gauze may be wrung out of lime water 
and placed over the inflamed and much swollen surface, keeping 
them very wet. At night an ointment of zinc oxide may be 
applied over a painting of " black wash " (to be obtained at 
drug stores). Poison (trifoliolate, or three-leaved) ivy re- 
sembles Virginia Creeper, and all nurses and caretakers should 
be able to recognize it. 

Another treatment for poison ivy which is said to be very 
efficient is as follows: Moisten a bit of cotton with a ten-per- 
cent solution of carbolic acid and apply to the affected area — 
then immediately (about one-half minute) wipe off this carbolic 
acid with another piece of cotton saturated with alcohol. 

Matches, roach powders, fly poisons, washing fluids, lye, paris 
green, antiseptic tablets, and pieces of green paper, should all 
be kept out of the child's reach; and, in case of accidental 
swallowing of any of them, the physician should be sent for at 
once, and with the message " Come ! " should be given the name 
of the poison swallowed — if it is known. 

After the antidote is given, soothing drinks are usually admin- 
istered, such as raw white of egg, milk, flaxseed tea, slippery 
elm, etc. 

Complete rest in bed is always essential, and external heat is 
necessary for the body chills easily as the child grows weak. 

Toothache may be temporarily relieved by applying an ice 
bag below the jaw, thus diminishing the flow of blood to the 



358 THE MOTHER AND HER CHILD 

tooth, and a hot-water bottle to the cheek, which causes the skin 
vessels to fill with blood, thus relieving the tension in the 
vessels of the tooth. 

If there is a cavity, a small piece of cotton moistened with 
oil of cloves and packed well into it may give much relief. 

Children and adults should make a bi-annual pilgrimage to 
the dentist, who seeks out beginning cavities, early treatment 
of which will prevent these dreadful aches and later ill health. 

BURNS 

Burns and scalds are not at all uncommon with children, whose 
eagerness to explore and desire to investigate often leads them 
into trouble. 

1. The simple reddening of the skin — slight burns and sun- 
burn — simply needs protecting oil, or equal parts of oil and 
lime water, and is to be covered with sterile gauze. 

2. The burns which destroy the outer layer of the skin, pro- 
ducing a blister, are treated much as a wound would be treated. 
The blister, if larger than a half dollar, should be opened near 
the edge with a needle which has been passed through a flame. 
The serum should be pressed out and the parts protected by 
a piece of gutta-percha that has been disinfected with some 
antiseptic solution ; this covering keeps the dressings from stick- 
ing, thus avoiding the destruction of the new-forming tissues. 

3. When the tissues are injured in the more severe burns, 
the surrounding flesh is carefully disinfected with boracic-acid 
solution, and the same dressing applied as described for the 
" blister burns." Balsam Peru is a healing balm for burns of 
this classification. 

If a child's clothes catch on fire he is instantly to be thrown 
on the floor and any heavy woolen fabric, such as a curtain, 
table spread, blanket, or rug, is to be thrown over him (begin- 
ning at the neck) and the flames thus smothered. The clothing 
is now cut off, and if more than one-third of the body is burned 
the child should be taken to the hospital for constant care; 
and if more than one-half of the body is injured recovery is 
doubtful. Great care should be taken in keeping the unburned 
portion of the body warm, as there is a great tendency for the 



ACCIDENTS AND EMERGENCIES 359 

child to become very cold as he weakens from both the nervous 
shock and from the absorption of toxins. 

Acid chemical burns are treated with baking soda, except 
in the case of carbolic acid (misnamed), which is treated with 
alcohol ; alkaline chemical burns are dressed in vinegar or lemon 
juice compresses. 

Methods for restoring the drowned should be understood by 
every man, woman, and youth. These methods are more fully 
taken up in works devoted to emergencies and will not be dis- 
cussed in detail at this time. 

FAINTING 

Consciousness is quickly restored to the fainting child by 
lowering the head — laying him flat on the floor — while an 
assistant raises the legs perpendicularly. Cold dashes of water 
may be slapped on the chest with a towel, while the face is 
bathed or sprinkled with cold water. Consciousness is usually 
quickly restored by the above suggestions, in connection with 
plenty of fresh air. 

A sudden blow on the head occasionally results in a severe 
condition known as concussion of the brain. There is a partial 
or complete loss of consciousness lasting from a few moments 
to an hour or two. Pallor of the skin and a sense of bewilder- 
ment accompany concussion of the brain. 

Rest, quiet, and darkness should prevail until the physician 
arrives and makes an examination. External heat to the 
extremities may be applied, but no stimulants are to be adminis- 
tered until so ordered by the physician. 

It is wise to seek medical advice in the case of odd or unusual 
behavior after a fall on the head. 



CHAPTER XXXV 
DIET AXD NUTRITION 

MOST interesting is the study of the food as it passes 
through the processes of digestion, absorption, assimila- 
tion, and oxidation — all definite and important parts of the 
great cycle through which everything we eat passes on its way 
from the table to the tissues. Elimination is the last step in 
nutrition, and is the process by which the body rids itself of the 
broken down cells and other poisonous and useless wastes. 
These various phases of bodily nutrition may be expressed in 
a single term — metabolism. 

What we eat and how much we eat must be carefully planned, 
for our body temple is really made of what we eat. If you 
were erecting a beautiful mansion you would not think of 
allowing cheap, trashy, and inferior building materials to enter 
into the construction of your home. Xeither should you permit 
unfit and inferior materials to become a part of the daily dietary 
of your little boy or girl, thus to become a part of their bodily 
structure. 

ASSIMILATION OF FOOD 

Following the process of digestion in the stomach and intes- 
tine, the nutritive food elements are absorbed through the wall 
of the bowel by the wonderfully adapted little villus, and dis- 
tributed by various routes to the uttermost parts of the body. 
The sugars (all starches are changed into sugar) are carried 
in the portal blood stream to the liver, where they are actually 
stored away in the form of glycogen which, in a most intelligent 
manner, is dealt out to the body from hour to hour as it is 
needed for fuel. If all the sugar, after a hearty meal, were 
poured into the circulation at once, the blood stream would 

360 



DIET AND NUTRITION 361 

be overwhelmed and the kidneys would be forced to excrete 
it in the urine. This unnecessary waste is avoided by the liver's 
storing sugar after each meal and dealing it out to the body as 
required. 

Likewise, the proteins also pass through the liver on their 
way to the body. Just what action the liver exerts upon pro- 
teins is not wholly known at the present writing. The digested 
fats are absorbed at once by the lacteals, the beginning of 
the intestinal lymphatic system, by which they are carried to the 
large veins at the root of the neck and there emptied into the 
blood stream. We have now traced our various food elements 
through the processes of digestion and absorption in the ali- 
mentary tract, some going through the liver, and others through 
the lymphatic system, until they circulate in the blood stream 
itself. 

It is from these food substances, circulating in the blood 
stream, that the various cells of the body must assimilate into 
themselves such portions as they require for purposes of heat 
and energy and for the repair of their cell substance. This 
specialized work of cell assimilation converts the dissolved 
watery food in the blood into solid tissues, exactly reversing 
the process of digestion. 

With a most profound intelligence, each of these body cells 
and tissues, bone and nerve fiber, muscle and organ, selects 
from the blood stream just its supply or portion of the food 
elements requisite to its upbuilding and maintenance. The 
mysteries of assimilation are effected by means of chemical sub- 
stances called " enzymes," similar to those found in the digest- 
ive organs, but acting in an entirely different manner, in that 
they build up solids out of liquids instead of converting solids 
into liquids. 

ELIMINATION OF BODY WASTES 

Metabolism consists of a twofold role — an upbuilding and a 
tearing down process. After the food is all digested, absorbed, 
and assimilated, having become a part of the bodily organ, bone, 
muscle, and nerve fiber, then begins the work of tearing it down 
— of liberating its heat and energy — to be followed by its 



362 THE MOTHER AND HER CHILD 

elimination from the body through the sweat glands, uriniferous 
tubules of the kidneys, etc. The carbohydrates (starches and 
sugars), together with the fats, are completely burned up in 
the body and are then eliminated in the form of water (thrown 
off through the sweat) and carbonic acid gas given up by the 
lungs. 

The proteins, or nitrogenous foods, are not so completely 
burned up in the body. The ashes which result from their com- 
bustion are not simple substances like the water and C0 2 of 
the carbohydrates. This protein ash is represented by a number 
of complicated substances, some of which are solid (protein 
clinkers), which accumulate in the body and help to bring about 
many diseases, such as gout, headache, fatigue, bilious- 
ness, etc. 

These protein ashes and clinkers are further acted upon — 
split up and sifted — by the liver, and are finally eliminated 
by the kidneys in the form of urea, uric acid, etc. The body 
being unable to store up protein, is often greatly embarrassed 
when one eats more of this substance than is daily required 
to replenish the waste of the body, for it must all be immedi- 
ately split up in the system, and the over-abundant and irritat- 
ing ashes must be carried off by the eliminating organs. Now, 
the overeating of sugars, starches, or fats, is not such a serious 
matter, as they may be stored in the liver and subsequently 
used; and even if they are eaten in excess of what the liver 
can care for they accumulate as fat or add extra fuel to the 
fires of the body, their ashes being carried off in the form of 
such harmless substances as water and carbon dioxid (CO„) ; 
but the overeating of protein substances is always a strain on 
the body and should be avoided. 

ELEMENTS OF NUTRITION 

There are seven distinct elements entering into the compo- 
sition of human foods — protein, starch, sugar, fat, salts, cellu- 
lose, and water, not to mention enzymes, vitamines, and other 
little-known chemical principles. These elements are all vari- 
ously concerned in the nourishment, energizing, and warming 
of the body. 



DIET AND NUTRITION 363 

PROTEINS 

The proteins are the structure builders of the body. While 
starches, fats, and sugars may be compared to the coal that 
feeds the locomotive, the proteins represent the iron and steel 
that are used from time to time to repair the engine and replace 
its worn parts. The essential chemical difference between starch 
and protein is that the latter contains nitrogen and a small 
amount of sulphur and phosphorus. The most common forms 
in which protein is used for food are the glutens of the grains, 
the legumes, nuts, cheese, the white of egg, and lean meat. 

STARCHES 

The starches are by far the most abundant of all elements 
in human food. They enter largely into the composition of 
nearly all plants and seeds. Under the influence of the sun- 
light, the green-colored plants gather up the C0 2 of the air 
and, with the water absorbed from the ground, build up starch. 
The plant takes all the carbon from which starch is made from 
the air, but while the atmosphere contains almost eighty per 
cent of nitrogen, the plant is unable to use it; it must secure 
its nitrogen from the decaying refuse of the soil. Thus the 
plant utilizes the waste products found in air and earth in the 
building of its food substances. 

Starch exists in the form of small granules. Since each little 
starch granule is surrounded by a woody envelope of cellulose, 
it becomes necessary to cook all starches thoroughly in order 
to burst this cellulose envelope and thus enable the saliva to 
begin, and other secretions to continue, the work of digestion. 

FRUIT SUGARS 

The sugar of fruits represents a form of food requiring prac- 
tically no digestion; while the sugar found in beets, the cane 
plant, and the maple tree, must be acted upon by the digestive 
juices of the intestine before their absorption can take place. 
During the winter, the maple tree stores its carbohydrates in 
its roots in the form of starch. With the advent of spring 
Mother Nature begins the digestion of this starch — actually 
turns it into sugar — and in the form of the sweet sap it finds 



364 THE MOTHER AND HER CHILD 

its way up into the tree trunk to be deposited in the leaves and 
bark in the form of cellulose, a process very similar to that 
performed by digestion in the human body, where starch by 
digestion is first turned into sugar, and afterwards deposited 
in another form in the liver and muscles. 

Dextrine is a form of sugar resulting from thoroughly cooking 
or partially digesting starch. There are about twenty-five stages 
or forms of dextrine between raw starch and digested starch or 
fruit sugar. Dextrine is found in the brown-colored portions of 
well-toasted bread. 

FATS 

Fat is a combination of glycerine and certain fatty acids. 
As a food, it is derived from both the animal and the vegetable 
kingdom. Animal fat consists of lard, suet, fat meat, etc., while 
fat of animal origin is represented by cream, butter, and the 
yolks of eggs. The vegetable fats are found in nuts, especially 
the pecan, cocoanut, Brazil, and pine nuts; also in the grains, 
particularly oats and corn. The peanut also contains a con- 
siderable amount of fat. Of the fruits, the banana and straw- 
berry contain a trace of fat, while the olive is the only fruit 
rich in fat. 

As a food, fat is used in three forms. The emulsified form 
is represented by cream, olive oil, and nuts. When the tiny 
globules of fat, which are each surrounded by a little film of 
casein, are crushed — united into a solid mass — we have a 
free fat. This form is represented by butter and other animal 
fats. Another form is fried fat — fat which has been chem- 
ically changed by heat with the development of certain irritating 
acids. 

MINERAL SALTS 

The mineral elements comprise but a small part of human 
food as regards weight, but they are extremely important to 
the health of the child as well as the adult. As found in the 
food, they are not in the form of mineral salts, like common 
table salt. The salts of food are living salts, organic or organ- 
ized salts, such as are found in the growing plant. These salts 



DIET AND NUTRITION 365 

are of great value to the various fluids of the body, and also as 
stimulants to nerve action, but more particularly in the work 
of building up the bones. 

Salts are found largely in the cereals. A small amount is 
also found in vegetables, particularly the potato, as well as in 
most fruits. 

CELLULOSE 

Cellulose represents the great bulk of all vegetables and 
fruits. It is digested by most animals, but in man it is digested 
only to the extent of about thirty per cent. The presence of a 
large amount of cellulose in the food enables us often to satisfy 
the appetite without injury from overeating. It serves to 
give bulk to the food, and thereby possibly acts as a preventive 
to constipation. 

WATER 

Water fills an important place in the nutrition of the body. 
The food changes in connection with digestion, assimilation, 
and elimination, can take place only in the presence of water. 
Water constitutes from fifteen to ninety-five per cent of the 
various foods. The watery juices of vegetables and fruits 
consist largely of pure, distilled water, in which fruit sugar 
is dissolved, with added flavoring substances. Water is abso- 
lutely essential to the performance of every vital function 
connected with human metabolism. 

ANIMAL HEAT 

The source of heat in the animal body was the subject of 
much superstitious speculation on the part of ancient scientists. 
It is now known that animal heat is derived from the food we 
eat by means of a peculiar process of vital oxidation — effected 
in the presence of oxygen — by the action of water and enzymes 
upon the food elements absorbed by the living cell. This process 
of oxidation liberates the heat and energy stored by the sun 
in the food, and thus the body is kept warm by this constant 
combustion of the digested foodstuffs. The starches and 
sugars, together with the fats, represent food elements which 



366 THE MOTHER AND HER CHILD 

serve as the body's fuel. By this means we are able to main- 
tain a constant body temperature of almost one hundred degrees. 
The average human body produces enough heat every hour 
to raise two and one-half pounds of water from the freezing 
point to the boiling point. This is equivalent to boiling about 
seven gallons of ice-water every twenty-four hours. Differ- 
ently expressed, the body gives off each hour the same amount 
of heat as a foot and a half of two-inch steam coil. This is 
the same amount of heat which would be produced by burning 
about two-thirds of a pound of coal. 

FUEL VALUE OF FOODS 

Expressed in terms of English weight, the fuel value of the 
three different food elements would be: 

i ounce of carbohydrates I2 7-5 calories 

i ounce of proteins I2 7-5 

i ounce of fat 289.2 

It will be observed that fat contains more than twice as much 
heat as the carbohydrates. This is due to the fact that fat con- 
tains more carbon than either starch or sugar. Next to fats, 
starches and sugars are the most important fuel elements. Pro- 
tein is a very extravagant form of food for fuel purposes. Pro- 
teins are the most expensive elements of human food; they are 
incompletely burned in the body, and inasmuch as they leave 
behind distressing and disease-producing ashes, it is clearly evi- 
dent that only sufficient amount of proteins should be eaten each 
day to supply the demand of the body for repairs. We should 
depend more largely upon the carbohydrates and fats for heat 
and energy. 

A large part of our food is required to furnish heat to take 
the place of that lost by radiation from the skin, and this is 
why children require more food than adults — they have a 
larger skin surface in proportion to their weight, and therefore 
lose more heat by radiation, and it is for this reason that the 
food for the growing child must be wisely and carefully 
selected. 



DIET AND NUTRITION 367 

DIET FOR CHILD TWO TO THREE YEARS OLD 

Breakfast, 7-8 a. m. : Fruit; cooked or toasted cereal served 
with thin cream; a soft boiled or coddled egg; bread (two or 
more days old) and butter; plenty of milk. 

Dinner, 12-1 : Soups; creamed vegetables — tomato, corn, 
peas, and celery; any two of potatoes — creamed, mashed, or 
baked — carrots, beets, spinach, peas, cornlet, squash, cauli- 
flower, asparagus tips, string beans ; protein dish — the puree 
of dried beans, peas, or lentils; macaroni or carefully selected 
meats ; dessert — apples, baked or sauce — or other fruits, 
junket, custard, milk. 

Supper, 5-6 p. m. : Fruit; bread (bran bread if constipated) ; 
milk; porridge, with rich milk or milk toast; sweetened graham 
crackers. 

FOODS ALLOWED CHILDREN OF FOUR YEARS AND OLDER 

Protein Dishes: Purees of dried peas; lentils; beans; maca- 
roni ; eggs — soft boiled, poached, scrambled, or omelette ; meats 
— steak, chops, chicken, turkey, broiled fish. 

Cereals: All the toasted-flake foods; toasted and not too fresh 
bread, including both graham and bran; hominy; corn meal; 
oatmeal; farina; rice; barley; tapioca; sago, etc. 

Soups: Creamed vegetable soups of all kinds and broths. 

Vegetables: Potatoes; all the small green vegetables; lettuce; 
stewed celery ; beets ; squash ; cauliflower, etc. 

Fruits: All, if stewed or baked. Raw fruits — pears, peaches, 
ripe apples, berries, oranges, persimmons, grape-pulp without 
seeds, etc. 

Desserts: Custard; jellos; junkets; home-made ice cream; 
sponge cake; baked fruits with whipped cream, etc. 

FOODS TO BE AVOIDED BY YOUNG CHILDREN 

1. Doughy breads, griddle cakes, insides of muffins, hot bis- 
cuits, etc. 

2. Fried meats, such as sausage, oysters, pork, ham, veal, salt 
fish, corned beef, dried beef, etc. 

3. Foods that arc hot when they are cold — such as catsup, 
horse radish, mustard, highly spiced pickles, sauces, etc. 



368 THE MOTHER AND HER CHILD 

4. Rich pastries, puddings, unripe fruit, salted peanuts, and 
highly concocted dishes. 

5. Certain salads, containing coarse but easily swallowed 
foods, with highly seasoned sauces. 

6. Tea, coffee, and all alcoholic beverages. 

7. Soft candies, chocolate creams, bon-bons, patties, etc. 

Average normal children crave sweets, and since their nor- 
mal food is about seven per cent sugar it is not to be wondered 
at. There are many forms of pure, hard candies which may 
be taken by the three-year-old child. They are stick candy, 
fruit tablets, sunshine candies, and other varieties which may 
be sucked. 

All soft candies, such as chocolate creams, bon-bons, patties, 
etc., are to be avoided. Hard candies, taken along with the 
desserts at meal time, in no wise injure the normal stomach 
of the healthy child. 

The other members of the family should set a correct example 
by sucking the hard candies rather than chewing them; for if 
the hard candies are allowed to dissolve slowly in the mouth 
they produce a weak solution of sugar, which does not interfere 
with digestion as do the strong and concentrated sugar solutions 
which result from chewing chocolate creams, bon-bons, etc. 

Candy, cookies, sandwiches, or bits of cake should never be 
allowed between the meals. 

EATING BETWEEN MEALS 

Children who do not eat well at the breakfast table, if given 
a " piece " at 10 a. m., will not be ready for the 12 o'clock 
meal ; and then another " piece " at 2 p. m. interferes with the 
normal appetite at 6 p. m. Digestion is disturbed, the nervous 
system irritated, and a " puny child " is often the result. 

Bring the three-or-four-year-old to a well-selected breakfast 
some time between 7 and 8 a. m. Then nothing — absolutely 
nothing — but water must pass the lips between that breakfast 
hour and the 12 o'clock meal, which should be a good one. 
Then the interval until 5 or 6 p. m. is passed in the same man- 
ner. At the evening meal the appetite is again whetted; and 
a good appetite always means good gastric juice to digest the 



DIET AND NUTRITION 



369 



meal. And so, good mother, guard carefully the interval 
between meals if you would have good digestion and good health 
for the little folks. 



DAILY FOOD REQUIREMENT 

The following table, taken from The Science of Living, * 
shows the minimum of calories or food units required by boys 
from five to fourteen years of age and girls from five to 
twelve : 

BOYS 









Skin 


Daily 


Age 


Height in 


Weight in 


Surface in 


Calories or 


Years 


Inches 


Pounds 


Sq. Ft. 


Food Units 


5 


41.57 


41.09 


7-9 


816.2 


6 


43-75 


45-17 


8-3 


855-9 


7 


45-74 


49.07 


8.8 


912.4 


8 


47-76 


53-92 


9.4 


981. 1 


9 


49.69 


59.23 


9-9 


1043-7 


10 


51.58 


65.30 


10.5 


"17-5 


11 


53-33 


70.18 


11.0 


1 178.2 


12 


55-11 


76.92 


11.6 


1254.8 


13 


57-21 


84.85 


12.4 


1352.6 


14 


59.88 


94.91 

GIRLS 


13-4 
Skin 


I47L3 

Daily 


Age 


Height in 


Weight in 


Surface in 


Calories or 


Years 


Inches 


Pounds 


Sq. Ft. 


Food Units 


5 


41.29 


39.66 


7-7 


784.5 


6 


43-35 


43.28 


8.1 


831.9 


7 


45-52 


47.46 


8-5 


881.7 


8 


47-58 


52.04 


9.2 


957-1 


9 


49-37 


57.07 


9-7 


1018.5 


10 


51-34 


62.35 


10.2 


1081.0 


11 


53-42 


68.84 


10.7 


1 148.5 


12 


55-88 


78.31 


11.8 


1276.8 



* Sadler, William S., The Science of Living ; or, The Art of Keep- 
ing Well. A. C. McClurg & Co. 



CHAPTER XXXVI 
CARETAKERS AND GOVERNESSES 

BECAUSE of her versatile adaptability to the management 
of details, woman, all through the ages, has willingly and 
happily sacrificed herself upon the altar of service. It is not 
in the province of this chapter to go into the details of the 
tribal life of the early hordes and clans that came from the 
north and from the east to establish civilization in the cities of 
Rome and Britain — space forbids. In this chapter we wish 
to hold up a picture to the mother, a picture which may speak 
volumes to her soul ; one which perhaps she may ruthlessly throw 
away — nevertheless, we propose to exhibit it. 

HOMEMAKING VS. HOUSEKEEPING 

A newspaper woman in my office recently told me a story 
of a mother who finished her high-school education, took some 
work in a university, and who yielded to the earnest pleas of 
her lover-classmate through grammar school, high school and 
college — and married him. To this happy family there came 
a number of beautiful children. The mother willingly, lovingly, 
cared for them during their helpless infancy — made their 
clothes, managed their meals, opened the door for them as 
they came home from school, met them with a cheery story, 
listened to their problems, helped them with their lessons — but 
all through it, first, last and ail the time, she also managed the 
entire home. She dusted the furniture, changed the curtains, 
looked after the linen, mended the clothes, and even pressed 
the trousers of her " rapidly rising " husband that he might go 
out into his " club life " and enjoy the evenings with his asso- 
ciates. The duties of the day so wearied her, and the night 
vigils with the sick child, — looking after the little coughs, the 

370 



CARETAKERS AND GOVERNESSES 371 

uncovered shoulders, getting the drinks of water and performing 
a dozen other details — that she was too weary to accompany 
her husband to the dance, to the theater, to the social gathering 
or to ladies' night at the club; and so, in the course of a dozen 
years, the mother had grown old, and quite naturally she had 
grown " home centered." Her world's horizon was the walls 
of her home. She was happy and quite contented in her chil- 
dren's smiles, in the cheery " how do you do " of her husband, 
in the fact that that gravy was good or that steak was fried to 
the king's taste. 

She was happy and contented until one day when the awaken- 
ing blow came. In the attic she and her thirteen-year-old son, 
who was just entering high school, were looking through an 
old chest when she drew forth some examination reports and 
some old school cards — holding them up side by side. One set 
of the cards bore the father's name and the other set the 
mother's maiden name. In great surprise the boy exclaimed, 
" Why, mother, I never knew you studied algebra and Latin ; 
why, mother, I never knew you were educated." Her eyes were 
immediately opened, the scales fell off, she was awakened to 
the fact that her own son was coming to regard his mother as 
somewhat inferior, in intellectual attainments, to the father — 
that she was considered in that home as a mere domestic. 
True, the steak had been broiled well, the pudding was 
exquisite, the children's clothes were always in order, the hus- 
band's trousers were always beautifully pressed, his ties were 
cleaned as well as a cleaner could clean them; but where did 
she stand in her boy's mind and where was she in her husband's 
mind? 

" Do you notice how trim and nice Mrs. Smith always looks ? 
Her clothes are always in the latest style, and she combs her 
hair so becomingly." Such remarks as this from the well-mean- 
ing husband cut keenly, and it is well that they do, for often 
it is only such remarks that wake up our " home mother." 

Dear reader, I want you to ponder this story. I wish to say 
to the mother who has started out upon a career in life, who has 
prepared herself for teaching school, for a business career, for 
story writing, for millinery, for lecturing, or has perhaps gradu- 



372 THE MOTHER AND HER CHILD 

ated in a domestic science course, that she makes the mistake of 
her life in settling down, just because she has taken another's 
name, to be perfectly satisfied with becoming the household 
domestic, the household mender, the household cook. 

MOTHERS IN THE PROFESSIONS 

I have in my acquaintance scores of mothers in the professions, 
newspaper women, women who have carved out brilliant careers 
for themselves, women who have taught school for twenty years 
while their children have been growing up, women physicians 
who have risen in the esteem of all their professional brothers 
and sisters, women who have conducted cooking schools, who 
have occupied positions of trust in hospitals and in every walk 
of life, and who have successfully reared children at the same 
time. 

You will pardon me for being personal when I say that 
since our own little fellow was six weeks old his clothes have 
been washed and mended and his food has been prepared by 
earnest and honest women who had not fitted themselves for 
the career which this boy's mother had chosen. His mother 
went to her office, cared for her patients, kept up by the side 
of her husband in the battle of life. All the time there was 
a woman at home just devoted to that little fellow. 

A newspaper woman recently told me her story — a story 
which should impress everyone of my readers as it did myself, 
and she, like many other mothers in the professions, leaves her 
home as the little fellow goes to school. His hands have been 
washed, his bowels have moved, his hair has been combed, his 
breakfast has been eaten by the side of his mother — she has 
directed it all. He goes forth to the schoolroom and she goes 
forth to her profession. All through the day she lovingly keeps 
in mind these children that are growing up. She works the 
harder, real love entering into everything she does, because 
she is not merely earning the bread that goes into their mouths, 
but is forming a character not only for herself but, because 
of her broadened horizon, is instilling into their little minds the 
possibilities of their own career, their own opportunity to enter 
into the world's work as real world workers. 



CARETAKERS AND GOVERNESSES 373 

I contend that the mother in a profession has many blessings 
that the mother who remains at home never has. The mother 
who remains at home has a viewpoint that is often quite likely, 
wholly unconsciously, of course, to become small, to become 
narrow, to become focused upon small details; on the other 
hand, the mother whose mind and whose heart are so full 
of the affairs of the office, of the newspaper article she 
has just written, or the lecture she has just given or is 
about to give, or the meeting that she is to preside over, is 
quite likely to become somewhat irritated sometimes if the little 
fellow doesn't stand quietly to have his hair combed, she is 
quite likely to " feel rushed ; " but under all circumstances, dear 
reader, whether this mother be a home mother or in a pro- 
fession, never, never must she allow mental panic to seize her. 
Ever must we keep in mind that these little ones are just children 
— children that are still in the developmental stage. 

WORK OUTSIDE THE HOME 

And now for the home mother. I believe it is necessary and 
of paramount importance that she get away from her children 
(if possible) several hours each day; that she provide for them 
a caretaker who can relieve the children of her or relieve her 
of the children, whichever way you may look at it, for we are 
inclined to think that the children often tire of the mother just 
about as often as the mother tires of the children. I would 
have the woman who remains at home, whose husband is able 
to provide outside help for the heavy work, of the house, 
enter into some uplifting neighborhood work, social set- 
tlement work, church work, wholesome club work — any- 
thing but bridge and whist and gambling games. I would have 
them bring into the nursery a woman who is cheery, who is 
capable of teaching games, of entertaining and amusing these 
little folks under their own roof. 

The woman who has graduated from high school, who has a 
diploma to teach, I would have take a school or, at least, do 
substitute work. She will be happier — far happier — con- 
tinuing along the lines for which she has prepared herself, even 
if all the money she earns be used to pay the help. Some 



374 THE MOTHER AND HER CHILD 

women are especially fitted for the important work of mother 
and homemaker, and such wives will find for themselves a 
worthy career in the home and its neighborhood activi- 
ties. Each woman must find a field of action suited to her own 
temperament, education, experience, talents, and opportunities. 

SELECTING A CARETAKER 

For a caretaker, the professional or business woman should 
not select an ignorant servant girl; that would be a great mis- 
take — a crime — a violation of the law that should govern 
the training of these little people who have come to us to be 
reared and cared for and fitted to occupy their place among 
the world's workers. As a rule, one soul does not possess the 
qualifications for scrubbing and laundry work and also the 
firm but gentle ministering qualifications necessary for a suc- 
cessful caretaker. They do not combine as a rule. It has 
been my experience, as a mother with a profession, and that 
of many others of my acquaintances, that an art student or a 
music student makes a splendid caretaker. There are hundreds 
and hundreds of genteel women, with winning manners and 
beautiful dispositions, who may be obtained to sew on the but- 
tons, wash the faces, and change the clothes of our darlings 
while we are carrying forward in the world the great work for 
which we have fitted ourselves during the long struggles of our 
teens and early twenties. 

The young woman who is brought in to care for the child 
should be above the usual " servant " class. She must eat in 
our dining-room, she should be welcome in the living-room or 
sun parlor, and be treated as a respected member of the family. 
Her salary is usually not large for she realizes that she is given 
something in that home — something that money cannot buy. 

THE UP-TO-DATE MOTHER 

Now this young woman (the caretaker) wants to hold her 
position, and so she is very anxious to carry out in detail the 
laws and rules that are laid down by the mother. Mother can 
keep abreast with the world, mother has time to read period- 
icals that keep her in touch with the great, wide, pulsating 



CARETAKERS AND GOVERNESSES 375 

affairs of life. She is able to meet more women worth while, 
and with her husband attend lectures, musicals, theaters, and 
other places for intellectual culture. 

Anyone of my readers need not look four blocks from her 
home to find a mother who is run down at the heel, whose 
dresses are calico, whose hat is five or six years old, whose 
black silk dress (the only one she ever had) is worn shiny 
or threadbare, who works and saves every penny that she can 
that her children may look well ; and, even when the husband 
does invite her to go out with him, he will often be confronted 
with this remark : " John, I would like to go, but really my 
clothes are a little bit shabby." The world is just full of such 
women, with their very hearts being eaten out of them for 
the want of a beautiful gown, a beautiful hat or a pretty pair 
of evening shoes, and they might have them every one if they 
would be willing to allow the duties of the household to be 
presided over by a woman that cannot do the things the 
mother can do, while she goes out and accrues a number of 
dollars each week which will more than provide for the things 
that her soul desires so that she may go well dressed by the 
side of her husband in quest of that very necessary intellectual 
culture and social diversion. 

The wife of a prominent judge, in my office just this week, 
said to me that she believed that most of our social and domestic 
uneasiness was due to the fact that fathers and mothers and 
children went out together so seldom. The father goes to 
his club, the children go to their little gatherings, and mother 
usually stays at home ; although of late, she is beginning to 
realize the value of the women's clubs. 

QUALIFICATIONS OF THE GOVERNESS 

The caretaker should not be too old. It is a very great 
blessing if there is an older sister in the family who can come 
in and assist with this work, or if there is an aunt. If one 
is to be selected from the open market, then we suggest a 
woman in her late teens or early twenties whose heart is full 
of play, whose face is sunny, and who is young enough to 
appreciate and like the becomingness of youthful dress. It is 



376 THE MOTHER AND HER CHILD 

needless to say she should be free from tuberculosis and other 
diseases. She should be trustworthy enough not to administer 
soothing syrups because the children won't sleep, or to give 
candy when mother has forbidden her, or to teach the children 
bad habits of any sort. 

It is impossible to exercise too much care in the selection of 
this substitute mother, and when you do find one it is often wise 
not to keep her too long. A year or so is plenty long enough 
for any person to be with our children. It is only necessary 
for anyone to walk out into the public parks and casually listen 
to the conversations of many of the " chewing-gum caretak- 
ers " to discover with what carelessness some people select 
caretakers for their children. The language they use is not 
only ungrammatical but oftentimes both slangy and profane. 
The flirtations carried on with many of the park policemen and 
bystanders lead us to feel that many people arrive at the idea 
that their little folks " will grow up some way." If the care- 
taker is a student, a young woman of culture, and is kept with 
the family, she will be found to be more circumspect and depend- 
able. Her gentleman friend, if she has one, should be allowed 
to come to the home. She does not have to meet him out in 
the park any more than a sister would have to go away from 
home to meet a friend; and, to my mind, everything centers 
around the viewpoint of the mother as sh . selects this care- 
taker, for if she is her social equal it puts her in a different 
place entirely to the well-meaning but ignorant servant girl to 
whose care is often intrusted the lives of the little people. 

HINTS FOR THE CARETAKER 

There are a number of hints we wish to bring together in 
this chapter for the mother to suggest to the caretaker. For 
instance, here is a group that one author gives us: 

BABY IS HAPPY BECAUSE 

He is dry. 
He is healthy. 
His food is right. 
He has sleep enough. 



CARETAKERS AND GOVERNESSES 377 

His meals are on time. 

He is dressed properly. 

He is bathed regularly. 

His habits are regular. 

His bowels move regularly. 

He has fresh air day and night. 

He is not dosed with patent medicines. 

He is not excited by frequent handling. 

He is not annoyed by flies or other insects. 

THINGS BAD FOR BABIES 

Candy. 

Pacifiers. 

Thumb-sucking. 

Soothing syrups. 

Patent medicines. 

Waterproof diapers. 

Moving picture shows. 

Sucking on empty bottles. 

Being kissed on the mouth. 

Play of any sort after feeding. 

Sleeping in bed with the mother. 

Whiskey or gin for supposed colic. 

Sneezing or coughing in the face. 

Irregular or too frequent feedings. 

Sleeping on the mother's breast while nursing. 

Spitting on handkerchief to remove dirt from baby's face. 

Allowing a person with a cough or a cold to hold the baby. 

Violent rocking, bouncing, and rollicking play at any time. 

Dirty playthings, dirty nipples, dirty bottles, dirty floors. 

Allowing any person with tuberculosis to take care of the 
baby. 

Testing the temperature of the baby's milk by taking the 
nipple in the mouth. 

THINGS TO REMEMBER 

Keep baby out of dust. 
Don't cover his face. 



378 THE MOTHER AND HER CHILD 

Don't rock him to sleep. 

Keep baby away from crowds and sick people. 

Don't neglect a sore throat or a running ear. 

His health, growth, and happiness depend largely upon you. 

Cats and dogs have no place about a baby. They carry dis- 
ease. 

The baby is not a toy or a plaything, but a great responsi- 
bility. 

Don't wipe out baby's mouth. It tends to cause ulcers and 
thrush. 

OVERCOMING BAD HABITS 

There are a few bad habits which older children fall into 
such as lip-sucking or thumb-sucking or finger-sucking which 
not only narrow and deform the upper jaw, but likewise deform 
the hand itself. They should be stopped at the earliest oppor- 
tunity by pinning the sleeve to the bedding or putting mittens 
on the hand or putting a slight splint on the anterior bend of 
the elbow. Some children suck their handkerchiefs, or bite 
holes in their aprons and neckties. 

Children often bite their finger nails, and a habit of this kind 
fully developed during early childhood often remains with them 
throughout life; whenever a nervous spell seizes them they 
instantly begin to bite their finger nails. Other people pick 
their nose when nervous, so during very early childhood these 
habits should be discouraged. One mother helped her little son 
by beautifully manicuring his nails for him each week. Another 
child was cured by old-fashioned spanking. The finger tips 
may be painted with tincture of aloes, or dipping the tips of 
the fingers in strong quinine water will sometimes help. I 
know of nothing better for the adolescent child than to teach 
him how properly to manicure his own nails. Another bad 
habit that children often get into is stooping or allowing the 
shoulders to become rounded. Shoulder braces are not indicated 
in these cases. The children should be allowed to enter the 
gymnasium or the father should take off his coat and vest and 
go through gymnasium stunts with the boy. The mother can do 
the same for the girl. It is often the case that round-shouldered 



CARETAKERS AND GOVERNESSES 379 

children are near sighted. The child really has to stoop to see 
things. When a child holds his head to one side constantly on 
looking at objects, astigmatism, an error of eyesight, is usually 
indicated. An eye specialist should be consulted, the eyes exam- 
ined, and properly fitted eye glasses should be worn. 

Just as early as possible in the life of the little child he should 
be taught to blow his nose, to spit out the coughed up mucus from 
his lungs, to hold out his tongue for inspection and to allow his 
throat to be examined. He should be taught to gargle, and to 
regard the physician as one of his best friends. Attention to 
these minor accomplishments will make it very easy indeed for 
the physician in case of illness. 



CHAPTER XXXVII 
THE POWER OF POSITIVE SUGGESTIONS 

A CHILD is the most imitative creature in the world. Be- 
fore he is out of pinafores he tries to talk and act just like 
his elders. It is because of this inherent tendency to say and 
do those very things which he hears others say and do, that, if 
faith-thoughts are early and constantly suggested to the unfold- 
ing mind of the child they will assist greatly in evolving a char- 
acter of joy, confidence, and courage. On the other hand, if 
fear-thoughts are continuously sown in the young mind they 
will eventually distort the emotions, deform the conceptions, and 
wholly demoralize the health and life activities of the growing 
child. Within the limitations of the possibilities of hereditary 
endowment, and in view of this wonderful imitative nature, we 
are able to make of a child almost anything we desire ; not " an 
angel," in the ordinary acceptation of the term, but a child who 
knows his place and possesses the power of normal self-control. 

EARLY FEARS 

From two to six years of age, when the imagination is most 
plastic and vivid, when the child's imitative instinct is so uncon- 
sciously automatic, is the most effective and opportune time to 
initiate good habits and lay the foundations for the later devel- 
opment of a strong and noble character. " Baby's skies are 
Mamma's eyes " is just as true as it is poetical. While a tired 
and worn-out mother, exhausted by a multitude of harrassing 
household cares, may be pardoned for her occasional irritability, 
nevertheless the little one unconsciously partakes of her spirit. 
When the mother is happy the child is happy. When Mother 
is sick and nervous the child is impatient and irritable. 

It is unfortunate that this very time of a child's life, when 

380 



THE POWER OF POSITIVE SUGGESTIONS 381 

we can do practically anything we choose with him, is the very 
time when so many parents fill the child's mind with the un- 
healthful fear-thoughts. " The bogie man'll get you if you don't 
mind Mamma," or, " I'll get the black man to cut your ears off," 
or, " the chimney sweep is around the corner to take bad little 
boys," are familiar threats which are so frequently made to the 
little folks. These efforts to terrorize the young child into 
obedience never fail to distort the mind, warp the affections, 
and, more or less permanently, derange the entire nervous sys- 
tem. The arousal of fear-thoughts and fearful emotions in the 
mind of the growing child is very often such a psychologic 
and a physiologic shock 'to the child that the results are some- 
times not wholly eradicated in an entire lifetime. 

Just see how far we carry this unwholesome introduction of 
fear-thoughts — even to the Almighty. Thousands of us remem- 
ber being told as a child that " God don't like naughty boys," or, 
" God will send the bad man to get you if you don't be good." 
Thus, early in life, an unwholesome fear of the Supreme Being 
is sown in the mind of the child, and, as time passes, these false 
fears grow and come so to possess the mind and control the 
emotions that in adult life this early teaching comes to mold the 
character and shape the religious beliefs of the individual. 

To the child who has been reared to dread God, who has come 
to look upon the Creator as an ever present " threat," how is it 
possible to convey the beautiful teaching of His fatherhood? 

FEAR OF NOISES 

How frequently some unusual noise leads a parent to say: 
" Keep still ! What was that? Did you hear that noise? " The 
little folks of the family are startled, their eyes grow large and 
their faces pale, while they cling to the frightened mother. Of 
course, investigation usually shows that the strange and alarm- 
ing noise was merely the slamming of a cellar door, the rattling 
of a curtain in the wind, some one walking about downstairs, or 
the action of the new furnace regulator in the basement. But 
meantime the harm is done to the children — fear, the worst 
enemy of childhood, has been unconsciously planted in the mind 
by the thoughtless and nervous parent. 



382 THE MOTHER AND HER CHILD 

FEAR OF DARKNESS 

Consider for a moment the thousands of children who are 
early taught an abnormal fear of the dark. Even when the 
child is absolutely free from such a fear, when sent into a dark 
room some member of the family will thoughtlessly remark, " Do 
you think it is quite right to send that child into that dark room ? 
Suppose something should happen." The child quickly catches 
the suggestion that something is supposed to be or happen in the 
dark, and in his mind is sown the seed of fear. 

When our boy was about two years old he was carried one 
night to the window by a caretaker, and as they looked out into 
the darkness the young woman said, " Boo ! dark ! " The little 
fellow shuddered, drew back and repeated, " Boo ! dark ! Boo ! 
dark ! " 

That night, as was our custom after the evening story, we 
tucked him in his little bed, turned out the light, and saying, 
" Sweet dreams, Darling," closed the door. Imagine our sur- 
prise to hear, " Mamma, Mamma, Willie 'fraid of dark, Willie 
'fraid of dark," and it was with difficulty that he was induced to 
go to sleep in the dark. Immediate inquiry revealed the occasion 
of his fears, and the next night we set about to eradicate the 
fear of darkness from the little fellow's mind. 

For ten successive nights we took his hand, and, leading him 
into a dark room, said, " Nice dark, restful dark ; we go to sleep 
in the dark; we're not afraid of the dark, no." Each night, 
save one, we were met with, " No, no, naughty dark. Willie 
'fraid of dark." On the tenth night as we entered the room as 
usual, repeating, " Nice dark, restful dark ; we go to sleep in the 
dark; we're not afraid of the dark, no," his little mind re- 
sponded. Suggestion had at last routed fear and given birth to 
faith. We had won ! But it had taken ten nights of constant 
work to undo one moment's work of a thoughtless girl. Every 
night since he has gone to sleep in the dark without a murmur. 

THE FOLLY OF MAKING THREATS 

Threats only show weakness on the part of the disciplinarian. 
Most school teachers early learn the folly of making threats. 
When I was teaching school I recall that a number of slate pen- 



THE POWER OF POSITIVE SUGGESTIONS 383 

cils had been dropped on the floor one afternoon. Thought- 
lessly I threatened, " Now the next child that drops a pencil 
will remain after school and receive punishment ! " My fate ! 
The weakest, most delicate girl in the room was the next to drop 
her pencil, and she was a pupil with a perfect record in deport- 
ment. The reader can imagine my embarrassment. I had 
threatened punishment, and so had to get out of the predicament 
as best I could. This experience effectually cured me of making 
such foolish threats. 

Most of us live to regret the threats we make. " Your father 
will thrash you when he comes home tonight," or, " You'd better 
not let your father see you doing that," or, " You wouldn't be- 
have that way if your father was here," etc., are common threats 
which we hear directed at headstrong and willful boys. What 
is the result? Do such threats cause the love of the child for 
his father to increase? They make the child actually afraid of 
his father. 

" I'll ' bust ' your brains out," said a four-year-old to his pet 
lion, because it wouldn't stand up. Now it should be remem- 
bered that these things do not originate in the minds of the boy 
and girl. They only repeat the things they hear others say. It 
betrays both cowardice and ignorance to undertake to secure 
obedience by such threats as " I will box your ears if you don't 
mind," etc. 

Obedience that is worth anything at all is only secured 
by suggestion and love, never by promises of reward or threats 
of punishment. 

CHILDREN WHO ARE CALLED " COWARDS " 

Recently we overheard a little fellow say, " Father says I'm 
the only coward in the whole family." Looking him straight in 
the face we said to him : " You're not a coward. Such a fine 
boy as you couldn't possibly be a coward." The boy was greatly 
amazed, and, as we left him, he was saying over to himself, 
" I'm not a coward. She said I'm not a coward," finally adding, 
" She said I couldn't be a coward." This one thought, repeated 
to him several times and turned over and over in his mind, 
eventually overthrew the false fears instilled by his father. 



384 THE MOTHER AND HER CHILD 

A short time ago the daily papers contained the story of the 
ten-year-old son of a New York business man who drew his 
few dollars from the savings bank, boarded a train for Chicago, 
and, after three days of amusement and loneliness, his money 
all gone, was found in a hotel bitterly weeping. His identity was 
revealed, the parents were notified at once, and the boy was sent 
on the first train back to his home. On the way to the station 
he sobbed out through his tears, " Well, my brother can't call me 
a coward any more, anyway." Who knows but that this ever- 
lasting taunting of the child with the accusation of being a baby 
or being a coward has much to do with many such escapades 
and other daring exploits on the part of the juveniles who are 
chafed by such unjust insinuations? Those of us who are 
acquainted with the vice and crime of a great city can imagine 
just what might have happened if this boy had been a little older, 
if his heredity had not been so good, if his money hadn't run 
out, if he had been able to remain in the big city long enough 
to make undesirable acquaintances. 

Many criminals have confessed behind prison bars that when 
they were children they were called cowards. After a while 
they actually came to believe that they were cowards, and in 
their efforts to acquire courage and demonstrate their bravery 
they were led to desperate and even criminal acts. They prowled 
around the dark alleys just to convince themselves that they 
were not afraid, that they were not cowards, and there they 
made the acquaintance of the criminals who led them into new 
and dangerous paths. Even if a child enters this world handi- 
capped by heredity, let us not lessen his chances of success by 
adverse suggestion. 

Faith-thoughts, thoughts of bravery and of courage, may 
just as easily be instilled into the mind of the normal child as 
thoughts of fear and cowardice. A child should never have 
suggested to him that he is afraid. He should be constantly 
assured that he is brave, loyal, and fearless. The daily repeti- 
tion of these suggestions will contribute much to the actual 
acquirement of the very traits of character that are thus sug- 
gested. This does not mean that a child should not be taught 
caution and forethought. 



THE POWER OF POSITIVE SUGGESTIONS 385 

THE GIRL WHO WOULD " TURN OUT BAD " 

Parents do not begin to realize how fearfully dangerous is 
this habit of constantly reiterated negative suggestion. Let me 
illustrate by an actual incident: A beautiful girl in a near-by 
state grew up quietly in the little village until she was eighteen 
3 r ears of age, when suddenly she decided to run away from 
home, declaring she was old enough to do as she pleased. She 
confided in one of her girl friends that she was going to Chi- 
cago, and had made all arrangements to lose herself in the 
" redlight " district. All that this girl friend said had not the 
slightest influence. As the train bore her away to the city and 
to ruin, a social worker in Chicago was wired to meet her at 
a suburban station. The girl was met, taken from the train 
and whisked in a cab to the home of a Christian woman. So 
possessed was this girl with the idea of throwing herself away 
that the captain of police was asked to talk to her ; but the 
combined efforts of the police captain, a magistrate, and several 
Christian people could not persuade her to recall her threat. 
She declared she would kill herself if her parents were notified. 
This siege lasted for ten days. Then she finally broke down, 
saying : " I simply can't help it. All my life my mother has 
told me that I was going to turn out bad. No matter what 
would happen at home, if I broke a dish or went out with the 
young people and remained away ten minutes later than I was 
told to, it would always be thrown up to me, ' Oh, some day 
you'll turn out bad.' I have heard it until I am sick of it, and 
something within seems to push me on and on, telling me I 
must turn out bad." 

Of course the girl was persuaded to believe that these were 
only fear-thoughts; that she was a beautiful, virtuous girl, that 
she simply had received the wrong training, that she couldn't 
possibly turn out bad. She was thus saved by the sympathy 
and advice of understanding friends, was subsequently married 
and is today the mother of a splendid boy. 

WHAT HEALTHY FAITH-THOUGHT WILL DO 

Here is another story which illustrates what healthy faith- 
thought will do. A young man was not long ago selected for 



386 THE MOTHER AND HER CHILD 

the highest position within the gift of a large religious organiza- 
tion. When he was a lad his parents held this thought con- 
stantly before his mind : " David, if you will be a good boy, 
if you will do what is right, you may some day be President of 
the General Assembly." He became a minister of the Gospel, 
a very successful one, and subsequently married a young woman 
who was also much interested in religious work. She continued 
to encourage him in this ambition, saying : " David, preach the 
best sermons you can; make an effort to bring many souls to 
Christ, and some day I believe you will be President of the 
General Assembly." The man presided over the General As- 
sembly of his denomination, not one term, but term after term. 
He kept his eye long fixed on that particular aim, and by faith 
he won it. 

THE POWER OF SUGGESTION 

To see how powerful suggestion may be in a child's life take 
this incident that every parent knows : The little one trips 
and tumbles. Mamma says, "Oh, did you fall? Well, never 
mind; come here, I'll kiss it. There, now it's well." Immedi- 
ately the child goes back to his play perfectly happy. One little 
fellow was taught that when he fell he should get up at once, 
rub the bump, and say, " That didn't hurt." All through his 
career the bumps and the hardships of life were met with the 
same pluck. On the other hand, a thoughtless caretaker will 
excitedly jump and catch up the slightly injured child, coddle 
it, rock it, pet it — and the crying continues indefinitely. This 
early training in meeting minor hurts and obstacles lasts 
throughout the lifetime. Pluck and grit are lacking. The be- 
havior of the man in the face of difficulties is foreshadowed by 
the attitude of the child toward his petty trials and bumps. 

Successful child training follows in the path of positive sug- 
gestion. Impatient words and careless threats of punishment 
can only contribute to the wrong training of the young mind. 

When is the best time to suggest to the child? Catch the 
little fellow when he is happiest, when he is overjoyed and 
filled with glee; for it is at such times that the suggestions 
offered will meet with the least resistance. 



THE POWER OF POSITIVE SUGGESTIONS 387 

Teach the children through the spirit of play and through 
the medium of the story. The boy or girl in the story always 
can have a clean face, always close the doors quietly, and other- 
wise so conduct himself or herself as to constitute a powerful 
positive suggestion for good. The story-child always says, 
" All right, Papa," " All right, Mamma," when corrected. 

•BEDTIME A GOOD TIME TO SUGGEST 

The " going-to-bed time " is the time par excellence for sug- 
gestion in early childhood. After the play time, the study 
time, and the evening story, when all is quiet, in the peaceful- 
ness of the darkness, while you are seated in a low chair close 
beside the little bed, with your hand in his, repeat over and 
over again the positive suggestions which you desire to take 
root in the mind and bear fruit in the character. Again and 
again tell the little fellow that he is the noblest and bravest of 
boys, that he loves truth and hates deceit. No matter what 
disturbs him, if it is the lessons at school or a wrong habit, 
first think out exactly what you desire him to be or to do, and 
firmly, but quietly, tell it over and over to him. 

As a concrete example: Suppose Henry, at three-and-a- 
half years of age has to be coaxed or almost forced to eat. Say 
to him : " Now, Henry, you are a good little boy. Papa and 
mamma love you dearly. If you are going to grow up to be 
a big man you must not forget to eat; so tomorrow when you 
go down to the table you will eat everything mamma or nurse 
puts before you. It won't be necessary for papa to feed you 
at all ; you will eat the potatoes, the gravy, the toast, and the 
cereal, and drink your milk. You will make mamma very 
happy, and papa will be proud of you; and then after dinner 
we will have a good romp, and you will soon grow up to be 
big enough to have a velocipede and a watch." After two or 
three evenings of this suggestion you will be surprised to see 
there is a great difference in his eating. 

Take the timid little girl who is unable to recite well at 
school, who is shy, and has great difficulty with her lessons. At 
the going-to-sleep time sit by the side of her bed and tell her 
that tomorrow she will have her lessons better, that she will 



388 THE MOTHER AND HER CHILD 

not any more be afraid, that she will get up and recite without 
the least fear in her heart. By constantly repeating these sug- 
gestions she will be given confidence, and in most cases it will 
result in effecting the deliverance of the child from her bond- 
age to fear. Never tell her that she is shy or that she cannot 
do things. Constantly tell her that she is a successful girl with 
a strong character, and that she is going to make a very useful 
and courageous woman. Hold high aims and ideals before her. 
Suggestion cannot atone for all the defects of character which 
may be inherited, but it can do much to help such unfortunate 
little ones gracefully bear their burdens. 

NEVER ACCUSE CHILDREN OF DISHONESTY 

Never tell children that you suspect they are dishonest or 
untruthful. Be very slow to accuse and suspect them of false- 
hood or theft. Tell them over and over again they are the best 
boys and girls in the world; that they are going to make the 
noblest of men and women; that they love honesty and truth. 
Even when you discover them in minor faults do not make 
the mistake of unduly magnifying and emphasizing the error. 
As soon as possible direct the thoughts and attention of the 
wrongdoer away from his error, and focus his thoughts and 
attention on the high goal you expect him to reach. This will 
not be construed as doing away with proper punishment for 
persistent faults after the more ideal methods seem to have 
failed. 

A patient recently called us to see her little girl, and as we 
made ready to make the examination the mother said : " Now, 
Mary, stop your playing and come and be undressed and let 
the doctor look at you." 

" I don't want to stop playing," murmured Mary. 

" But you must come. You know you don't feel well at all, 
your cheeks are so red. Now swallow and see if it don't 
hurt. Now try again. I know you don't feel well." By the 
time we had begun our examination Mary began to succumb 
to her mother's suggestions, and began to feel a trifle indis- 
posed. She was being made temporarily ill by the unwise and 
unfortunate suggestions of the overanxious mother. The ex- 



THE POWER OF POSITIVE SUGGESTIONS 389 

amination revealed that there was nothing whatever the matter 
with her. 

IT IS EASY TO FORM GOOD HABITS 

Let us get the truth firmly into our minds as parents that 
it is just about as easy to form a good habit as a bad habit, 
just about as easy to acquire helpful, happy thoughts as those 
that are injurious; and we can do it, if we will but see to it 
that our children early form correct and proper habits of think- 
ing and acting. While the children are taught proper respect 
for authority, let fear be an unknown word to them. Don't 
let a thought of the fear of insanity, of haunted houses, of 
drafts, of this and of that enter into your home. Instead, live 
in the glorious sunshine of strong, healthy, faith-thought, and 
a supreme happiness will come into your life, and you will give 
a legacy to your children for which they will " rise up and call 
you blessed." 

CHIVALROUS SPIRIT 

The love of mother and sister can naturally and happily be 
turned early to a chivalrous attitude toward all women when 
it is developed by suggestion and other training. In giving up 
a chair or bringing one for a guest, in lifting the hat, in noticing 
ways to be polite and attentive to mother, a lifelong conduct may 
be ensured. 

Each day gives us trying and sometimes shocking revelations 
of the prevalent lack of courtesy, or even humanity, on the street 
cars during the " rush " hours. The indifference to the comfort 
of women, even the aged, on the part of many men and boys in 
the matter of giving them seats or other care, indicates a dan- 
gerous social condition. 

The mother, instead of exercising selfish concern for her 
boy, should make it her duty very early to suggest that he give 
his seat to a woman or girl, as he would be glad to have some- 
one do for his mother or sister. Such unselfish service will 
become a habit of pleasure, and help the boy become a pure- 
minded, manly gentleman with that respect for womanhood 
without which a nation is doomed. 



CHAPTER XXXVIII 
PLAY AND RECREATION 

THERE are a number of theories advocated by late authors 
on the " psychology of play," in which they connect the 
free and easy play of the modern child with the more serious 
and sober pursuits of our ancestors — our racial parents of 
prehistoric and primitive times. We quote from Worry and 
Nervousness: 

And so we are told that the spectacle of the young infant suspend- 
ing its weight while holding on to some object, and the early in- 
stincts so commonly shown to climb ladders, trees, or anything 
else available, are but racial mementos of our ancestral forest life. 
The hide and seek games, the desires to convert a blanket into a 
tent, the instinct for " shanties " — which all boys universally mani- 
fest — we are told that these forms of play are but the echo of remote 
ages when our ancestors sojourned in caves, lived in tents, or dwelt 
in the mountain fastness. In this same way the advocates of this 
theory seek to explain the strange and early drawings which the 
young lad has for wading, swimming, fishing, boating, and other 
forms of aquatic recreation.* 

In this chapter we purpose to discuss the play of the child, 
whose career we will divide, for convenience, into three stages : 

1. The age from three to six — juvenile days. 

2. The age from six to twelve — the " going to school " child. 

3. The age from twelve to twenty — the adolescent youth. 

JUVENILE PLAY DAYS 

As nearly as is possible the little child should be out of doors 
the greater part of his waking hours. To our mind it is nothing 



* William S. Sadler, Worry and Nervousness, p. 377. 

390 



PLAY AND RECREATION 391 

short of criminal to keep the little folks in the house when the 
weather permits outdoor life. 

Of the outdoor games which we have to suggest, perhaps 
the sand pile stands at the head of the list. Clean white sand 
should be placed in an inclosure just low enough for the child 
to climb over. Many, many happy hours may be spent in this 
sand pile, at the same time the little fellow is in his own yard 
and the watchful mother knows the drift of the conversations 
which take place. 

In a previous chapter we called attention to the fact that the 
little girls' frocks should be provided with knickerbockers, so 
that she may run and jump, or sit as comfortable as the little 
boy, without a conscious reproof ever ringing in her ears, 
" Mary, do keep your dress down." 

OUTDOOR PLAY 

Tree climbing is another source of enjoyment to these little 
people and they should early be taught how to climb. Instead 
of suggesting fear to the child let the mother go into the yard 
and talk with her something like this : " Now, Mary, put your 
foot in that fork, now catch hold of that upper limb, hold on 
tight, you will get there yet;" instead of the following con- 
versation, which all of our readers have heard: "John, do 
take care or you will fall and break your neck; be careful, you 
will fall. There, I knew you'd fall ! " etc. Both mothers are try- 
ing to accomplish the same thing — one mother suggests " fore- 
thought," while the second mother thoughtlessly suggests 
" fear-thought." 

These little, people should be provided with rakes, spades, and 
hoes, and a portion of the yard should be given them in which 
they are at liberty to dig and rake and have a royal good time. 
We have yet to see the child who is not interested in flower- 
bed making, and the mother should think of the virgin oppor- 
tunity to instill the story of life into the child's mind as he 
plants the seed, and day by day watches its development and 
growth. 

A pen of rabbits may be a good thing, if proper measures 
are taken to prevent their burrowing out of the pen, destroying 



392 THE MOTHER AND HER CHILD 

the lawn, causing much sadness of heart to their little keeper, 
and no end of annoyance to the neighbors. 

Roller skating and hoop rolling, as well as sledding, are all 
valuable recreations. The snowman, snowballing, and the sled 
riding all bring the ruddy glow of health to the cheek, and are 
wonderful producers of good appetites and restorers of " tired 
out nerves." 

INDOOR GAMES 

There is no end to the number of things that can be done 
when the weather shuts us in, but before we take up these 
games let us never forget that every child thoroughly enjoys 
going out in the rain well protected with rubber boots, raincoat, 
and umbrella. 

It is not extravagant to burn plenty of electricity or gas on 
cloudy days, for the artificial sunlight helps to cheer the heart. 
Such indoor games as those which may be had from blocks, 
puzzles, cutting out of pictures, darning of cardboard, soldier 
games, dolls, housekeeping, etc., are all splendid means of rec- 
reation for the little ones. Let the mother or caretaker join 
with the little folks in these pleasant games. For the older 
children, checkers and dominoes are most excellent indoor 
games. 

THE " GOING TO SCHOOL " CHILD 

First of all we must decide upon the bedtime hour, as well as 
the hour for rising. Between the ages of six to twelve, the bed- 
time hour should be eight o'clock, or not later than eight-thirty, 
and the rising hour at seven, or seven-thirty in the morning, for 
children of this age require eleven to twelve hours sleep. 

Again, there must be taken into consideration the home work 
that the children at school are asked to do by their teachers. 
While this home work is not usually taxing, yet the time spent 
in doing the work must be taken account of. In our opinion 
the best time for home work is an hour and a half to two hours 
after the little fellow gets home from school. He should be 
allowed to relax for one and a half or two hours, to play out 
of doors whenever the weather permits, and then with either 



PLAY AND RECREATION 393 

his mother or his caretaker from one-half to three-quarters of 
an hour should be spent on the lesson for the following day. 
Following this, the dinner hour is enjoyed with the parents, 
and after that there should always be provision in the daily 
duties of the father and mother for at least a half hour for the 
evening romp; so that play and recreation during the school 
age occupies possibly not more than two or two and one-half 
hours a day outside of school hours. 

The playgrounds of schools are of inestimable value, and we 
quite agree with one who said : " If we can only afford one of 
the two — the playground or the school — have the playground 
first and afterward the school." The small parks and play- 
grounds of the cities are a great blessing to the little folks. 

COMPANIONS 

The companions of the school child are usually his playfel- 
lows at school, and we urge the throwing open of the home 
during inclement weather to allow these school friends to come 
in and make trains out of our chairs and tents out of our 
couch covers, steamer rugs, afghans, etc. 

We do suggest that caution be used in allowing children to 
play indoors who are suffering from colds in the head, running 
noses, running ears, tuberculosis, or other chronic disorders, 
which are often highly contagious. Running noses and running 
ears, as well as tuberculosis, may be contracted by susceptible 
children when the play at recreation time takes place indoors; 
while such disorders are much less dangerous in connection 
with outdoor play. 

We are well aware of the fact that some playmates may 
choose the bathroom, requesting that doors be locked, or wish 
to play in a bedroom securely away from mother and the care- 
taker. Under no circumstances should this be allowed. Let 
the child early learn that good wholesome play in the open is 
better than secretive misdemeanor behind closed doors. 

THE " IN THE HOUSE " HOUR 

It is a pitiful fact that many mothers apparently are wholly 
unconcerned as to the whereabouts of their little folks, even 



394 THE MOTHER AND HER CHILD 

after dusk; this is unwise to say the least, for a boy or girl 
under twelve years of age should be found under the parental 
roof at dusk. The city mother should impress upon her child 
that when the street lamps are lighted his first duty is at once 
to come into the house. During the winter months this light- 
ing of the street lamps occurs anywhere from four to six. Dur- 
ing the summer months another rule should be laid down, de- 
pending upon the neighborhood, the character of the friends on 
the street, the surroundings, etc. By all means let us see that 
our young people are in the house by dusk. 

PARTIES 

Every mother who reads these lines has had to meet this 
question : " Shall I let my little one begin to go to parties ? " 
and every mother will have to answer that question for her- 
self. We personally feel that the social life extended by the 
school, together with the meeting of the companions at Sunday 
school, in the park, or on the playground, is quite enough; and 
we deplore the fact that many children grow into the idea that 
much time must be spent at " parties " in the drawing-room 
under unnatural surroundings, in dressed-up clothes, eating 
ice cream and cake, etc. Outdoor gatherings of children are 
wholesome and hygienic, but most of these indoor gatherings 
of groups of children we consider decidedly unhygienic. One 
child coming down with scarlet fever, measles, or whooping 
cough can infect twenty others at an afternoon party. The 
eating of so much ice cream, candy, and cake is deplorable in 
that it upsets the digestion, and all this is irritating to the de- 
veloping nervous system of the child; and not infrequently 
brings on a lot of other symptoms, resulting in discomfort and 
disease. We believe in outdoor picnics but not in too frequent 
indoor parties. 

PICNICS 

Groups of children gathering in the park, on the beach, in the 
woods, when well chaperoned, are among the pleasant and 
profitable pleasures of childhood. It is just such gatherings 
that mothers and children should indulge in — and once a week 



PLAY AND RECREATION 395 

is not too often during the long vacation. The mothers, too, 
should enter enthusiastically into the joys of a day's outing, 
where the enormous intake of oxygen, the hearty laughter, the 
races, the games, etc., all create a wonderful appetite, which 
can be so delightfully satiated from the well-filled lunch bas- 
kets; and while the children are thus playing together what a 
wonderful opportunity for the mothers to engage in an ex- 
change of helpful ideas. Each mother has her own way, which 
is " the best way " to make this cake or that salad ; or has 
met this particular difficulty in child training in a carefully 
thought out way; a neighborhood women's club can thus be 
held out in the open, while the children are having the time of 
their lives in the frolic of the picnic. 

" MOVIES " 

The movie is an institution that has come to stay, and today 
mothers everywhere are perhaps discussing this particular insti- 
tution more than any other. The movie affords a wonderful 
opportunity to see the sights and scenes of other lands, of feed- 
ing the imagination of the child on travel pictures and nature 
pictures. It is a most deplorable fact, however, that this won- 
derful institution which is fraught with so many opportunities 
to educate and enlighten the mind of the growing child has 
carefully to be censored. Women's clubs have done much to 
purify the movies for the school-age child; many theaters are 
now showing on certain days a special afternoon movie for the 
children; and while many of these movies have great possibili- 
ties for good, we most earnestly urge that the school child see 
the movie that he is to see before dinner, and not have his mind 
excited and his nervous system " thrilled " just before going to 
bed. Someone asked me several years ago, " Are you going 
to let your little fellow go to movies?" I instantly answered, 
" No, but I shall take him." If the mother or the father sits 
by the side of a growing child and carefully, thoughtfully, and, 
yes, prayerfully, points out the good and explains the evil, then 
even the questionable movies will prove the means of bringing 
father and son and mother and daughter, into closer compan- 
ionship. 



396 THE MOTHER AND HER CHILD 

Under no circumstances should children under twelve years 
of age be taken to long lectures, entertainments, or concerts, 
which will keep them out until eleven 

VACATIONS 

Let the vacation be well planned. This is the opportunity 
" de luxe " for the child to earn a few pennies to enlarge his 
bank account. Allow him a truck garden, guinea pigs, chickens, 
anything remunerative, which will enable him to become one 
of the world's workers and one of the world's savers. Let 
him start a bank account wdien he is six, and watch him as he 
puts the dime in the bank, instead of taking it to the ice-cream- 
soda cashier. 

Some time during the vacation, if possible, mother and father 
should accompany the little folks to the camp, to the beach — 
somewhere, anywhere — to get back to nature and live like 
Indians for a short time. Each member of the family will come 
back rested, happier, and more ready for the next year's work. 

In the summer time learn to eat on the porch — it is great 
sport for the children. Many meals can be served on porches 
that are so often served in hot, stuffy rooms. 

The " home " does not consist in the furniture, the rooms, 
the bric-a-brac, or the curtains. The home is the mother and 
the father and the children and the spirit of good fellowship 
which should possess them. Make the companions of the little 
folks very welcome, letting them learn the early use and abuse 
of the different articles of furniture in the house. It is all right 
to play tent with the beautiful couch cover; it is all right at 
certain times to dress up in father's best clothes and mother's 
beautiful gown, but while they are thus having a good time let 
them learn that all these things are to be used and not abused. 

ADOLESCENT DAYS 

The homely boy or the homely girl usually grows up free 
from the flattery and undue attention which are sure to be 
heaped upon the good-looking boy and the popular girl. Way 
back in the early days of five or six, and all the way up to the 
ages of twelve to twenty, children should be taught that it is 



PLAY AND RECREATION 397 

altogether natural and correct to do things well and to look 
well ; parents should stop, and cause their acquaintances to stop, 
" making over " the boy or the girl just because they have done 
something well, or have beautiful curls, or because their eyes 
are a magnificent brown, etc. If a girl should be especially 
endowed with a charming complexion, a wonderful chin, and 
if she does possess a beautiful nose or neck, let her early realize 
that she has been made the custodian of goodly features and 
that she must give an account for this particular blessing, and 
under no circumstances must she become self-conscious about 
it. Ofttimes a good frown to an unwise friend is all that is 
necessary to stop this " lip service " flattery. 

The " chewing-gum girl " is just a thoughtless girl, that is 
all; sit her in front of a mirror and compel her to chew gum 
for one-half hour and watch herself do it, and it will often 
suffice to cure her. Young ladies should be taught that chew- 
ing gum should be done in the bedroom, but never in the living- 
room or on the streets. It is not only a disgusting habit, but 
it often creates an occasion for criticism as to the quality of 
one's home training. 

ICE-CREAM PARLORS 

The mother who cares will not allow her lovely daughters 
nightly, or even semi-weekly, to frequent the ice-cream par- 
lors and secluded soda fountains. She had far better arrange 
group dinners and group receptions in her own parlor; with 
ice cream served in her own dishes and eaten with spoons that 
she has supervised the washing of. 

Young women and young men in their late teens crave com- 
panionship, and they should have it; but let it be under wise 
chaperonage at home or in public rooms, and not in the solitude 
of a lonely bench in the public park, or the seclusion of an out- 
of-the-way, ice-cream parlor. This " running the streets " 
which is so freely indulged in by the adolescent youth in the 
early teens need not occur, if wise provision is made for the 
assembly of small groups in the home. 

Some elders think it pleasing and cute for young men and 
young women — fourteen to sixteen, or even seventeen — to 



398 THE MOTHER AND HER CHILD 

wrestle and roll around on the floor like two huge kittens; but 
it is unwise and indiscreet and should be discouraged. 

DANCING 

We hesitate to speak of dancing for we realize it is a very- 
popular indoor recreation of today, but we most earnestly urge 
that if dancing must be done, it be done under proper chap- 
eronage, and if young people must meet in public dance 
halls let them be municipal dance halls, where motherly matrons 
are in charge. Many of the social dances which bring the par- 
ticipants into such close physical contact are to be discouraged 
and stricken off the list; and while dancing is a splendid form 
of exercise — let us add that it is also sometimes a danger- 
ous one. 

QUESTIONABLE PLAY 

After the boys and girls graduate from grammar school they 
may come into contact with such agencies as secret societies — 
which nine times out of ten are questionable — and while we 
realize that there is a contention both for and against these 
organizations, we may dismiss the subject here by simply add- 
ing that we have known little special good to come out of these 
societies. 

While it may not be any more wrong to hit a ball from the 
end of a stick — as in billiards — <than it is to hit it from a 
mallet in croquet; or from a stretched tendon, as in tennis; or 
from a bat, as in baseball — we do not feel that we have to 
argue the point, when we remind the reader that billiards and 
pool, especially in the public parlors, do assemble questionable 
companions, who use questionable language; while these games 
are often accompanied by betting, which is always to be de- 
plored. And so with card playing, we see no greater harm in 
playing a game of euchre, than a game of authors, as far as the 
cards are concerned, but your boy and girl, as well as mine, as 
a rule, have cleaner and purer minds at the home game of 
authors than is probable in a game of cards in a public place. 

In closing this chapter we have to announce a group of 
wholesome recreations which may be entered into by our lovely 



PLAY AND RECREATION 399 

young people — the man and the woman of tomorrow — whom 
we one and all wish to keep clean and good and pure; all the 
while helping them to develop the sense of humor and the ele- 
ment of play. Such recreations are tennis, golf, croquet, roque, 
boating, sledding, skiing, bicycling, motoring, horseback riding, 
and a host of others too numerous to mention. Let us not for- 
get that ofttimes pursuits such as garden-making and helping 
the parent in the office or in the home, may be made a great 
source of enjoyment to the adolescent youth, if they are allowed 
to earn a small amount of money each week, which they may 
deposit in the bank. 

We close this chapter " Play and Recreation " with the wish 
that all, old and young, would develop a greater sense of humor, 
a greater love for play and recreation, which will increase the 
health of both mind and body and prevent many nervous dis- 
orders such as neurasthenia. 



CHAPTER XXXIX 
THE PUNY CHILD 

IN every neighborhood there is to be found the delicate child, 
and everywhere anxious mothers are putting forth every 
effort to improve the condition of their puny boys and girls. In 
carefully looking over the puny child, we see an underweight 
little creature with pale skin, and as he comes to the table 
everybody notes that he refuses more or less food. 

DIET AND HYGIENE 

As we give the child a closer examination we find that cer- 
tain lymph glands are enlarged, possibly adenoids are present 
in the post-nasal pharnyx, and, in many instances, there are 
badly diseased tonsils. Usually the puny child is constipated, 
hands and feet are cold, and he jumps and starts at any unusual 
noise, thus showing a tendency to nervousness. One of the 
first things necessary is to take this little one to a good spe- 
cialist and if necessary have the adenoids and tonsils removed. 
This having been done, the diet should be carefully looked into. 
There should be served him for breakfast a generous bowl of 
dextrinized grains with a good portion of diluted cream, a 
glass of rich milk, a baked potato, and fruit. For lunch at 
twelve o'clock he should be given a glass of malted milk with 
egg, or eggnog, six or eight dates or three or four figs, a hand- 
ful of pecan kernels, and perhaps a lettuce sandwich. For din- 
ner at half past five, another nourishing meal of baked potatoes, 
a protein dish of either cheese and macaroni or eggs or meat, 
a generous fruit salad, a glass of rich milk, and bread and but- 
ter, should be enjoyed. 

There is no class of little folks who eat between meals more 
often than do these delicate children, for mothers painstakingly 

400 



THE PUNY CHILD 401 

endeavor to feed these children all they can possibly take; so 
one mother thoughtlessly went about it something like this: the 
half past seven breakfast having been only touched — nibbled 
at — with the ten o'clock hour came this request : " Mother, 
I am so hungry, I want something to eat." Eagerly the mother 
prepared either a meat sandwich or a jelly sandwich and pos- 
sibly a glass of milk. 

When it was time for the twelve o'clock dinner hour, or 
lunch hour, again the well-filled plate was refused, the appetite 
having been satisfied at ten o'clock. Having taken very little 
nourishment at noon, by half past two the plaintive plea again 
came to the mother ears: "May I have a piece?" and again 
the well-meaning mother gave him the desire of his heart. So 
the day passed, the dinner making the fifth time food was 
taken into the stomach, and in all probability there was eaten 
a cookie in between. The reader can readily see that the diges- 
tion was consequently very much disturbed, fermentation oc- 
curred, decomposition of food took place in the digestive tract, 
with its result — constipation. 

IMPROVING THE APPETITE 

Not a morsel should pass the lips of any child, and particu- 
larly our delicate child, between meals. Let him come to the 
table at half past seven or eight o'clock, and if he does not 
want to eat tell him frankly that that is all he is to receive until 
twelve — and stick to it. Nothing more than water or fruit 
juices should be taken between meals. 

It may be necessary to create an appetite for the three meals 
we have just described, and as we now take up the outdoor 
hygiene we would not forget that some simple treatment should 
be instituted each day in a well-heated bathroom or bedroom. 
Roller skating or ice skating, hoop-rolling, rope-skipping, and 
Irish mail, or a coaster, all furnish splendid exercise for the 
delicate child. Under no circumstances should he be allowed to 
remain all the time in the house; and so pleasing recreations 
must be provided for him out of doors. The sand pile should 
not be forgotten, flower-bed making, raking the lawn, a polished 
coasting board fastened in a slanting position to an upright 



402 THE MOTHER AND HER CHILD 

which can be mounted by means of a ladder, create splendid 
outdoor sports for these children. 

THE DAILY PROGRAM 

Take the child into a warm bathroom each morning and let 
him stand in six inches of well-warmed water. With a rough 
mitten made out of either mohair, crash, or turkish towel, the 
entire body should now be rubbed until it is pink. This pro- 
cedure is known as a dry-friction rub. Do not stop until the 
skin is pink, particularly the arms and legs, for the back and 
chest usually get pink quickly. Then with simply a cold dash 
of water to the feet, dry them well and allow him to dress. 
Twenty minutes before the meal hour, let him get out of the 
house and roller skate around the square as many times as he 
can in twenty minutes, or let him race and have a royal good 
time in the fresh morning air and then after this forced oxygen 
intake let him come in to breakfast. 

And now for school, and as we say " school," we regret that 
there are not more " open-air schools." Some day the Ameri- 
can people, more particularly the American mothers, will 
awaken to the fact that we need more schools with simply win- 
dow space rather than so many closed glass windows. Some 
day we will send our children with sweaters, leggings, stock- 
inet caps, mittens, even in the cool days of spring and fall, to 
" open-air schools," and in the cool fresh air they will think bet- 
ter and work faster and make wonderful progress in both 
studies and appetites. 

The particularly delicate child, under treatment, will not 
spend the whole day in school. In all probability the forenoon 
session only will be attended, after which the half-past-twelve 
or one-o'clock meal that has been previously described will be 
given him. Now if the appetite is variable, arrange a little 
surprise for him by serving this meal on the porch or in the 
living-room by the open grate, or out under the trees. In all 
probability such a meal will be taken eagerly, particularly if 
the mother will read a pretty story. Now the afternoon is to 
be spent in doing a number of different things. We would 
like a pleasant walk, a visit to the park, hoop-rolling, roller- 



THE PUNY CHILD 403 

skating, rope-skipping, ice-skating, outdoor sliding, anything 
that will take our little fellow out of doors to increase his 
oxygen intake until possibly the half-past-three hour is reached, 
when he should come into the house and lie down and prepare 
for the treatment for that particular day. 

TREATMENT SUGGESTIONS 

Twice a week he should be given a salt glow (described in 
the Appendix). Twice a week he should be given a thorough 
soap shampoo (also described in the Appendix). After each of 
these baths a special rub should be administered to the spine, 
and as there is so often spinal curvature in these children, cer- 
tain stretching movements of the spine are valuable, together 
with hot fomentations (see Appendix) over the spinal centers. 
These are wonderful stimulants to the delicate child and should 
precede the salt glow twice a week. Every afternoon a hot- 
and-cold foot bath may be given to create a better circulation. 
The feet are put in hot water from three to five minutes (as 
hot as can be borne), and then they are quickly plunged into 
the coldest water obtainable for three seconds, then back "into 
the hot water, and vice versa, until three changes have been 
made, always finishing the treatment with the cold dip. On the 
three remaining days of the week at half past three, the child 
will simply relax in the hammock or on the porch couch while 
the mother aids in the relaxation by a pleasant story. We 
would suggest that on Monday the salt glow be administered; 
Tuesday a rest is taken; Wednesday the soap shampoo is to be 
administered; Thursday another rest; Friday a salt glow; Satur- 
day another rest, and Sunday the shampoo, etc. 

Before going to bed at night, with the mother's hands well 
oiled with either olive or sweet oil, the circulation is again 
stimulated by the heavy friction rub. 

Constipation is taken care of along the same lines as men- 
tioned elsewhere in this book. 

It is surprising to see how often these delicate children are 
infested by worms, and while a great deal of dependence can- 
not be put in that single symptom " grinding the teeth at night," 
or " pallor around the mouth," yet we do believe that many 



404 THE MOTHER AND HER CHILD 

a delicate child continues to suffer from worms many years. 
It is a very simple procedure to obtain a specimen of the stools. 
A cathartic should be given and after usual free-bowel move- 
ment, the second time the child desires to go to stool this should 
be saved and taken to the laboratory for a careful search for 
worm eggs which are usually in evidence if worms infest the 
child. The treatment for worms is described elsewhere in this 
work. 

We have seen scores of young people between the ages of 
eight and eleven who, before treatment, were pale, listless, 
under weight, irritable and cross, after three months of such 
treatment as has been outlined gain six to ten pounds and look 
as ruddy as their healthiest neighborhood friends. It is per- 
fectly marvelous to notice how a child will put on from six 
to eight pounds in a short period, at the same time overcom- 
ing his irritableness and fretfulness. I am more and more in- 
clined to believe that most bad children are sick children — 
are undernourished children — and it behooves us American 
mothers and fathers to give proper attention to this under- 
nourished child, call a halt, and devote three months to giving 
him the help that he needs. He did not ask to come into this 
world ; and it is " up to us " to give this child what he deserves 
— for every child in this world has a right to be well born, to 
be well fed, and to be well reared. 



CHAPTER XL 
TEACHING TRUTH 

WE confidently believe that most of the sex immorality 
seen in young people is more or less the result of 
ignorance and curiosity; therefore we most earnestly desire in 
this chapter to portray so interestingly the beautiful story of 
life as seen in the vegetable and animal world, that our mother- 
readers will be seized with the great desire wisely to convey to 
the young child's mind this sublime and beautiful story. The 
questions most naturally arising in the mind of the reader at 
this time are: When shall we begin to tell this story? How 
shall we tell it? Where shall we begin? Where shall we 
stop? Realizing full well that the subject is usually handled 
prematurely and with unpreparedness, we will attempt in this 
chapter to discuss it with courage and candor, believing that 
there is a right way, a right time, and a right place to impart 
this information. 

A LESSON FROM NATURE 

When the little folks are about three or four years of age, 
when confidence and trust are at their height, they often come 
to us begging for a " story ; " and this is the golden opportunity 
for the parent or caretaker to tell them the story of Mr. and 
Mrs. Corn, and all their little babies ; or Mr. and Mrs. Morning 
Glory and their little folks. There are a score of other equally 
interesting and instructive botanical stories which are just as 
beautiful in their sublimity, and fairy-like in their personality. 
The little children's eyes grow big with wonder as you tell the 
story of a whole township of families by the name of Corn (See 
Fig. 17), who have their residences out in the wide country 
fields. 

405 



406 



THE MOTHER AND HER CHILD 




Ovules 
Seed Babies 



Fig. 17 



Fig. 18 



TEACHING TRUTH 407 

We will first introduce the child to Mr. Corn, the tassel, wav- 
ing proudly and majestically in the breezes, and seeming to 
say : " I am master of all I survey." The little fellow is filled 
with wonderment as he learns how the clouds give up their 
drops of water to quench his thirst and how the sun smiles 
upon him to yellow his beard; and how the wonderful all- 
important pollen is developed and ripened. 

Often the child eagerly asks, " And where, mamma, is Mrs. 
Corn? " and to that interested upturned face we relate the pleas- 
ing story of the beautiful silken tresses of Mother Corn. Early 
in her life she is a beautiful shade of green, and as she thus 
gracefully hangs out from the ear of corn, day by day the 
smiles of sunshine turn this mother corn to brown, and then to 
a still darker shade. 

" And where, mamma, are the babies ? " the child next in- 
quires; and, as we take the ear of corn, removing the outer 
clothing — the husks — we find the underclothing, a much 
lighter shade of green, and here now we are in close contact 
with the babies themselves — the kernels — and to each little 
kernel or baby corn we find mamma closely clinging. Here is 
a beautiful opportunity to teach mother-love and mother watch- 
fulness, as also the opportunity to draw lessons from the baby 
kernels sitting there in even rows, with their faces clean, 
silently contented — just doing their duty. The stories that 
may be told are limitless, and possibly as interesting as are the 
myths and fairy-tales, yet all the while as true as truth itself, 
with no fakery, no legends — just simple truth. 

THE ALL IMPORTANT POLLEN 

Now on a second trip into the cornfield, another story may be 
told of the important work of the pollen. This " father part " 
of the plant falls upon the silken tresses of the " mother part," 
by which the pollen is carried down to the sleeping corn-baby 
seeds — the kernels. And when the " corn dust " does reach 
the sleeping seeds a great change begins to take place. This 
change is known to the adult as " impregnation ; " to the little 
child it may be presented as " an awakening " of the sleeping- 
seeds, so that they begin to grow, to develop, to expand and 



408 THE MOTHER AND HER CHILD 

push out, until we have the full-grown seeds seen in the deli- 
cious and juicy roasting ear. 

Sometimes, in the case of the larger plants and trees, Father 
Tree may be miles and miles away from Mother Tree and so 
this all important pollen must be carried by the wind or by the 
bees, and as it blows against the mother part of the plant-flower 
she catches it and pushes it downward to the seed babies. The 
wind scatters the pollen of the oak tree, the hazlenut, the wal- 
nut, the birch, the willow and many others; for, without the 
good kind wind or the bees, the pollen would never find its way 
to many a mother flower, and the " fertilization " of the seed 
could not take place. 

THE MORNING GLORY FAMILY 

Perhaps the story of life can be told as beautifully from the 
morning-glory as from any other flower. Here the beautiful 
flower cup is the home of Father and Mother Morning-Glory 
and all their little babies. (See Fig. 18). 

As we carefully take away their little home, the flower 
cup, we have left a little green cup, and coming up from 
the center you will see five little stems, every one of them 
wearing a hat of powder or pollen and this — if you 
please — is Papa Morning-Glory. Look closely and you will 
see coming up from the center of these five stems (stamens) 
one central stalk without a hat, Mother Morning-Glory, known 
in botany as the " pistil " ; and as you follow down this pistil 
you will find an enlarged part at the base, which is known as 
the cradle-nest — the home of the seed babies. 

Little was known about this wonderful fertilization of the 
seeds by the pollen two hundred years ago, and a whole cen- 
tury passed before the secret of the blossom and the bees was 
discovered; and even then it was not fully realized how great 
was the work of the bees in cross-fertilization. Nor was it 
understood that the beautiful blossom of the flower, with its 
sweet nectar, was an exceedingly important factor in attracting 
the bees. Another century passed before Darwin gave to the 
world the story of the great work performed by the bees in 
cross-fertilization — in carrying the pollen from flower to 



TEACHING TRUTH 409 

flower, for it is now a well-known fact that all of the blos- 
soms visited by the bees produce better fruit and better flowers. 
In the flower where the father and mother part matures at 
the same time, self-fertilization is the rule. Cross-fertilization 
occurs in instances where either the father part or mother 
part ripen at different times, in these cases the pollen is carried 
from plant to plant by the wind or by the nectar-seeking bees. 
These busy bees, with their fluffy little feet and fuzzy coats, 
become completely covered with this all-important flower dust, 
and in seeking nectar from other flowers they leave the " awak- 
ening dust " behind, and thus cross-fertilization takes place ; 
new types of babies are produced, new generations of fruits 
and flowers. 

HOW MOTHER NATURE WORKS 

Dr. Chadwick, in her Blossom Babies, gives us a beautiful 
recital concerning the fertilization of plants, which provides 
an endless number of interesting stories. The water plants 
are very interesting in that the pollen is just light enough to 
float on the exact level of the mother part of the flower, other- 
wise fertilization could never take place, and there would be 
no more lovely lilies. Long throated blossoms are fertilized 
by their attraction for certain moths or humming birds who 
have long tongues. Mother Nature is exceedingly careful to 
reproduce her children, and in every conceivable way she 
sees to it that her plant-seeds are fertilized and distributed. 
We are all familiar with the dandelion and the thistle and a 
host of others which fly through the air with actual plumes, 
some seeds fly with wings, such as the maple ; other seeds travel 
by clinging or sticking, such as the cockle burr ; still others 
float and shoot; while we all know about a lot of seeds that 
are good to eat, such as the nuts and fruits, as well as many 
of the grains, such as corn, etc. 

An incubator about hatching time is a wonderful object 
lesson in teaching the story of life. Take the children to visit 
one and let them actually see the live baby chicks coming forth 
from the seed-shells. Other wonderful lessons may be drawn 
from the mother horse or the mother cow; and it is impossi- 



410 THE MOTHER AND HER CHILD 

ble to portray the close companionship, the sublime trust and 
confidence, which exists between the mother and the child who 
have been bound together by these ties and sentiments of truth- 
fulness, trustfulness, and frankness. 

THE SALMON FAMILY 

The little fellow is daily learning that everything that 
grows comes from a seed, even the salmon which was eaten at 
lunch yesterday was the text for an impressive story about 
Papa and Mamma Salmon. In the beautiful Columbia river 
Mother Salmon is swimming about quietly seeking a shallow 
place in the stream where she may deposit her cluster of baby 
seeds, which looks very much like a mass of tapioca pudding 
as they gently sink to the bed of a shallow spot in the river. 
There they lay " sound asleep " until Father Salmon, swim- 
ming by, is attracted to the spot and, hesitating, talks something 
like this to himself : " Why the idea, here are some helpless 
fish-baby seeds, they can't grow and develop without me, here 
they are sound asleep ; " and, nestling over them, he contributes 
the self-same and all important " something " — comparable to 
the pollen of the plants — which wakes them up. In the case 
of the fish the " awakening " substance is not in the form of a 
powder as in the plant world; but is in the form of a semi- 
liquid mass, much resembling the white of an egg. The little 
seeds soon begin to tremble — begin to wake up — and then 
begin to swell and grow and develop. In a few days what do 
you suppose happens to these little bulging baby seeds? the 
very same thing that happened to the chick seed — they burst 
and out come hundreds of cute little fish minnows. In just 
a few hours they are all swimming about in a most wonderful 
fish-like manner. 

EARLY QUESTIONS 

Some day you will be surprised by your little child suddenly 
asking you some such question as this : " Mother, where did 
I come from ? " while in the same frank manner you reply : 
" Why from your mamma, of course ; where do you think you 
could have come from? Everything that grows comes from 



TEACHING TRUTH 411 

its mamma — oranges, apples, radishes, cabbages, cats, dogs, 
and chickies — everything that grows has to have a mamma 
and papa ; " and they are often satisfied with this answer for 
a long time. No child should go to kindergarten without 
knowing that he came from his mother, and this knowledge 
should come to him from his own mother's lips. These are 
different days than those in which our grandmothers lived. 
The spirit of investigation and of inquiry is in the air. The 
moving-picture show makes it necessary for children of nine 
or ten to understand these things — to have a knowledge of 
certain of the conventionalities of life. Twenty years ago this 
may not have been so necessary — the youth of that day might 
have waited several years longer for certain phases of his sex 
instruction. It is highly important that this knowledge be ob- 
tained from a wise and pure and sympathetic mind — from the 
child's own parents. 

One mother put her little girl's questions off week after 
week, saying : " I will tell you when you get older, dear — no, 
not now, dear; run away, you are not old enough to know 
such things, you must forget about them." Thus the unpre- 
pared mother sought to gain time in which to consult the doc- 
tor or the library. Finally the day came when the mother 
felt that she was sufficiently wise to answer the query, " Where 
did I come from," and so with her heart in her throat she 
approached her daughter, saying : " Come, Mary, mother is 
going to tell you all about it. I am now ready to answer your 
question." Imagine her surprise and astonishment when Mary 
said : " Oh, you needn't mind, mother, Kate told me all about 
it last week." Now the question in my mind is : how did 
Kate tell her? How much unnecessary information did this 
older and experienced Kate put into the pure mind of this inno- 
cent little girl? 

ONE MOTHER'S AWAKENING 

One mother in a western state — a county superintendent of 
schools — told us the following interesting story of her own 
experience, which we think may be of help to some of our 
mother readers. 



4 i2 THE MOTHER AND HER CHILD 

One morning her seven-year old son rushed into the house 
exclaiming: "Oh, mother, there is a new calf out in the 
barn, and I know where it came from; I saw a wagon load of 
calves come by here yesterday, and one of them must have 
dropped off, for it is right out there in the barn with old Bess 
this minute." 

The mother was very busy with her papers and her reports, 
and she let the incident pass with a smile, thinking it was 
a very pretty little story. A week later the six-year old 
brother came in saying: " Mother, I think there must have been 
another wagon load of calves passed by, and one must have 
been lost off, for old Nell is cleaning up a little calf out in 
the barn for all she is worth," while the older brother piped up : 
"Sure, it was another load of calves; that is just exactly the 
way the other calf got here;" and the two little fellows went 
off to school. 

About a month later that county superintendent suddenly 
became a much wiser mother than she was before, although 
her heart was made to ache. Both boys came home from 
school one day and the older one met her with something 
like this : " I am mad ! I've been lied to ; all the fellows at 
school say I have, and they are making sport of me, too," and 
with a glare in his reddened eye he continued, " You know 
that new calf did not come off that wagon; you know that 
calf came from old Bess herself; all the fellows say so at 
school, and they are making all kinds of fun of me, and I 
don't want to go back. I'd like to run away from home." 
The mother quietly drew the boy to her side and reminded him 
that she had simply listened; that she had not opened her 
mouth; that he came into the room and told about the incident 
himself, but this did not satisfy him. He turned to her wounded 
and crushed, saying: "Well, you let a fellow believe it, and 
that's just as bad;" and this educated mother — this trusted 
custodian of a county full of school children — beseeched me to 
warn mothers everywhere to teach their children the truth, 
and to never let a child go to school with a sex misunderstand- 
ing. She told me that it took her six months to get that boy's 
confidence back again. 



TEACHING TRUTH 413 

don't get shocked 

I believe that many mothers make the sad mistake of show- 
ing the child that they are shocked by trivial sayings and tri- 
fling experiences of their little people. If we could only get 
it into our heads for once and for all that our children are 
born into this world veritable little thieves and falsifiers, as 
well as adventurers and explorers, we would then cease being 
so shocked and outraged by their frank statements of what 
they have heard or have done. Let the mother listen to all these 
things with calmness, while she seeks to direct the child's mind 
in pure and elevated channels — to help him upward by im- 
parting "precept upon precept; here a little and there a little." 

Children will come in with stories that at first thought do 
greatly shock the parent; but under no circumstances should 
the boy or girl discover that the parent is shocked, for if he 
does he will not likely come again with another such " shock- 
ing " difficulty. One mother told me that her seven-year-old 
boy, beginning third grade, came into her bedroom one morn- 
ing saying: "Mother, I am just busting to say something," 
and this mother very wisely said, " Well, say it ; certainly I 
don't want you to burst," and she told me that this boy whis- 
pered to her three of the filthiest words that he could possibly 
have heard on the streets. In relating this experience to me 
she said : " Do you know, doctor, that I really did not know 
what to think at first, but I remembered that you had taught 
me never to be shocked, and so I looked up and asked : " Do 
you feel better?" whereupon he breathed a big sigh and 
exclaimed: "What a relief! I have just been busting to say 
that to somebody." Mother, to whom would you rather he 
would say these things? to you, or to some little girl out on 
the street, or to some older boy? Think what trouble and 
possible mischief were avoided by whispering into the sympa- 
thetic ear of mother. This wise mother turned to that little 
boy and said: "Son, that ear is always waiting for just such 
things and whenever you feel like saying something — like 
getting it off your mind — you just come to me;" and he 
came repeatedly. One time he came in saying : " I don't 
know whether you want me to play with Harold or not ; he does 



414 THE MOTHER AND HER CHILD 

some of those things you told me about the other day." And 
the mother thoughtfully and wisely looked up and said : " Did 
he do it in front of his mother? Why of course he didn't. 
" Did he ask you to go into the bedroom or bathroom and lock 
the door?" and the little fellow quickly answered: "Why 
sure he did; how did you guess it?" and added "now I sup- 
pose you are not going to let me play with him any more," 
and this wise mother, knowing that if she denied him this 
privilege that it would quite likely be frequently sought, said: 
" Why, certainly play with Harold in the open, but whenever 
he suggests secrecy — " she did not have time to finish the 
sentence, the boy said: " I am wise; whenever he gets to doing 
that ' funny business ' I'll skiddoo." The confidence between 
that mother and son, to my mind, was wonderfully sublime — 
all the while practical and helpful in his daily training. 

don't repulse the child 

A little older child sees the fowls, the dogs, or the cats, 
" mating," and then, rushing into the house, inquires what it 
is all about; and unless the mother is on her guard some older 
member of the family may show surprise and thus thought- 
lessly convey to the child's mind that his question is improper 
and entirely out of place. To the question, " What are they 
doing, mamma?" quietly answer, "Just mating, dear, just as 
the flowers mate; everything that lives or grows comes as the 
result of mating." 

Suppose that you were repulsed every time you approached 
a dear friend, your husband, or some other member of the 
family? Take, for instance, the matter of a caress or an 
embrace — how would you react to repeated rebuff? And 
so with the little child; he comes into this world full of confi- 
dence and trust, full of wonder and curiosity; possessed with 
the spirit of exploration and investigation — everywhere and 
all the time he asks questions. Usually, his questions are 
answered thoughtfully and without hesitancy, except along the 
line of one thought — that of sex. Do not think for one 
moment that he is satisfied by your evasive answers. You 
have but to recall your own childhood experiences, and 



TEACHING TRUTH 415 

remember that today the moving picture show and general 
public sentiment has placed the age for such knowledge from 
one to five years earlier in this generation than in the past. 
I do not care what the child comes into your presence with, 
be it the most shocking thing in this world, do not under any 
circumstances let it disturb your mental poise, or raise your 
ire or shock you ; for if you do, then and there — at that 
moment — occurs a break in the sublime confidence which the 
child reposes in you. 

NECESSARY MORAL TRAINING 

While we are using the plant and animal world as object 
lessons in teaching our children the facts of sex and the secrets 
of life; while we face the commonplace sex matings of the ani- 
mals about us without cringing, without appearing to be 
shocked when our children call attention to these things; 
nevertheless, when the child is old enough to take cognizance 
of these phenomena, he is old enough to begin to receive some 
definite instruction from his parents regarding the moral phase 
of these great biologic problems. We cannot safely and indefi- 
nitely utilize the animal world as an object lesson in sex edu- 
cation, without at the same time emphasizing the moral differ- 
ence between man and the beast. 

Many parents treat these sex problems so lightly and en- 
deavor to act so naturally and unconcerned about these ques- 
tions, that the child comes to look upon the promiscuous sexual 
relations of the animal world as something altogether natural; 
and, unless proper moral and religious training is carried on 
at this time, he stands in danger of coming to regard lightly 
the moral standards of modern society. 

At the same time of life that Mother Nature fully develops 
the sex instincts — at adolescence — she also awakens the relig- 
ious emotions; the one being so necessary for the proper and 
adequate control of the other. Let parents take a cue from old 
Mother Nature, and at the same time the sex relations of ani- 
mals are freely discussed with the growing child, let the mother 
or father wisely call attention to the fact that but very few 
of the animals live family lives as do human beings. In this 



416 THE MOTHER AND HER CHILD 

connection valuable use — by way of illustration — can be 
made of the ostrich and some of the ape family who are loyal 
and true to their chosen companions. 

Moral and religious instruction must accompany sex-hygiene 
teaching just as soon as you leave the realms of botany and 
enter the sphere of zoology. We could here relate many a 
tragic experience which our patients have passed through as 
a result of volunteering too much sex knowledge and at the 
same time neglecting this very necessary moral instruction. 

SANTA CLAUS AND THE STORK 

We must bear in mind that the child believes what we tell 
him; he trusts us implicitly and we owe it to him to teach him 
the truth in answer to his numerous questions. We must 
keep his confidence. Take the matter of Christmas, for 
instance. How many confidences have been broken over the 
falsehood of Santa Claus and the chimney. Two little fellows 
hesitated in their play in the back yard, and the following 
conversation was heard : " You know that story about Santa 
Claus is all a fake." " Sure it is, I know it isn't so, I saw my 
father and mother filling the stockings. You know that stork 
story is all a lie too, there's nothing to it, babies don't come that 
way, and now I'm investigating this Jesus Christ story, I sup- 
pose that's all a fake too." The fact of the matter is, that 
while these children have discovered the truth of the first two 
stories, for a long time they will query the third story, for to 
them, that too is mysterious and fairy-like. They hadn't seen 
Santa or the Stork and had only heard about Jesus. 

STORY OF THE HUMAN BABY 

The story of the human baby may be told to any child of 
seven to ten years. Each mother will have to decide in her 
own mind the right time to go into the details of the human 
baby seed. The child should have had an opportunity to have 
planted some seeds in the ground, to have visited an incubator, 
or to have visited the farm and observed the family groups of 
babies — the chicks, pigs, calves, etc. — with their mothers. 

Let me see now how many different baby seeds do we know? 



TEACHING TRUTH 417 

Yes, we do know the radish seeds, many flower seeds, chicken 
seeds, bird seeds, corn, potatoes, and many others, and we can 
tell them all apart. The boy and girl baby seeds are too tiny 
to be seen with the eye. They are so small that it takes about 
two hundred of them in a row to make one inch. We can 
only see these human baby seeds with the aid of a microscope. 
It is such a precious seed that it cannot be intrusted to the 
ground or to a tree nest for development. The great Wise 
Father decided that a mamma would love and care for it bet- 
ter than anything or anybody in all the world. So, just as 
there is a cradle bed in the mamma flower, so there is in the 
human mother's own warm body, tucked far away from the 
cold rains and the hot sun, a little bed, for the boy and girl 
baby seeds. Right near to this little seed bed Mother Nature 
has prepared a little room, which holds the tiny " waked up " 
seed for nearly a year as it slowly grows into a little baby girl 
or baby boy. 

THE MATING STORY 

You remember the story of how Bob Robin found Jenny 
Robin, don't you? You remember mamma told you how Bob 
came up from the southland early in the spring and asked 
Jenny in lovely bird song to come and be his very own wife? 
How he promised her he would feed her on cherries, and cur- 
rants and the fattest of worms? And that she told Bob she 
loved him and went to live with him, and how they built that 
cute little nest to hold the eggs; and how Jenny Robin sat on 
the nest until the little baby robins were all hatched out. 

Well, one day papa found mamma. He met her and loved 
her dearly and told her he wanted her to come and live with 
him, and they built their home nest and were very happy 
together, because they decided they would always love each 
other more than any one else in the world. After mamma 
and papa built their home and lived together, one day a won- 
derful change came to one of the baby seeds and it awakened 
and began to grow. Mother Nature whispered to it, and told 
it how to find its way into this little room and there it clung 
to the wall and grew for nearly a year. Papa brought mamma 



418 THE MOTHER AND HER CHILD 

nice things to eat, just as Bob Robin did Jenny. Papa did 
everything he could to make mamma happy and comfortable. 
For nearly five months this little seed just grew and did not 
let anybody know it was there, until one day it began to tap 
against the sides of the walls of this little room, and every 
time it did mamma's heart just bounded with joy as she thought 
of the precious seed growing to be a darling baby — and all 
inside of her very own body. And one day, after nearly a 
whole year had passed, the door to the room began to open, and, 
very soon, a lovely baby found its way out of this special room 
into the big, big world. Mother Nature then told this little 
baby that it might still remain close to the mamma it had been 
with so long, and so she taught it how to get its food every 
day from mamma's breast. At this point the child usually 
breaks out by saying, " Now, mamma, I know just why I love 
you so much." 

UNFOLDING THE TRUTH 

I shall always remember with pleasure my own son, not quite 
two-and-a-half years old, who sat at the table one day asking 
numerous questions such as, " Mamma, what is that ? Mamma, 
where did that come from?" etc. 

He picked up a navel orange, and pointing to the navel said, 
"What is that?" 

I frankly said to him, " Why, my dear, that is the baby 
orange." 

" Why, Mamma," he exclaimed, " do oranges come from 
oranges ? " 

"Certainly, dear child; where else could they come from?" 

" But," he says, " Mamma, do potatoes come from potatoes? " 

" Why, honey," I said, " Orange babies come from orange 
mammas, potato babies from potato mammas, grapes come 
from grape mammas, little kitties from kitty mammas, and lit- 
tle boys from their mammas." 

We simply mixed all the babies up, just as you would mix 
up a delicious fruit salad. We took from the mind all ques- 
tion of mystery and surprise by quickly and honestly answering 
his question. Thus, his first knowledge of his origin, if he is 



TEACHING TRUTH 419 

able to recall it, will ever be associated with oranges, grapes, 
potatoes, kittens, etc. 

We did not tell the whole story for some two or three years 
later, but day by day we simply answered the questions as he 
asked them. 

One day, when he was about three, he burst into my bed- 
room, saying, " Mamma, dear, I did come from you, didn't I ? " 

"Why, yes, darling, from nobody else; just from your own- 
mamma and papa." 

" Say, mamma, was my hand in your hand, my foot in your 
foot, my head in your head? " 

" No, dear," I replied, " You were all curled up as snug as 
a little kitty is when it's asleep, and you slept for nearly a 
year in a little room underneath mamma's heart." 

It was a wonderful story. He threw his chubby arms about 
my neck, his legs around my waist, and said : " You dear, 
dear, mamma. I do love you and papa more, just awful 
much." 

THE DOCTOR'S PART 

In my private sitting-room, where William and I have had 
many conferences, there hangs my medical-class picture with 
classmates and faculty. A member of my family was one day 
answering the boy's queries as to who this one or that one 
was, etc. Finally, on pointing to one particular face, the 
answer came to his inquiry, " That's Dr. P. You wouldn't 
be here if it wasn't for him. That evening the little fellow, 
just past three years, came to me and asked, " Mamma, didn't 
you say I came from you?" 

" Yes, dear," I replied. 

" Well, Auntie says I wouldn't be here if it wasn't for Dr. 
P. What did the doctor have to do with it ? " 

" Why, simply this, dear. The door to the little room in 
which you grew in mamma's body wouldn't open, and so kind 
Dr. P. came and helped open the door." 

" And let me out? " exclaimed the eager child. " Oh, I want 
to go and see Dr. P. and thank him for helping me out ! " 

And this little fellow was neither shocked or surprised, any 



420 THE MOTHER AND HER CHILD 

more than he was over finding out that orange babies came 
from orange mammas. 

In the same frank manner in which the simpler questions 
are answered, strive to answer these important ones. If we 
seek to evade, to postpone, to wrap in mystery these sex ques- 
tions, the little ones will not forget but will ponder and worry 
over them, and seek to obtain certain knowledge from others 
who oftentimes tell too much or too little, and such informa- 
tion is usually mixed with much unnecessary matter which 
may or may not be foreign to this particular subject. On the 
other hand, if we frankly and honestly answer the question at 
hand, curiosity is avoided and the child feels he understands 
it all. The subject drops into the background of his mind — 
into the marginal consciousness — with the countless other 
facts he has accumulated. A sense of " knowledge posses- 
sion " is as comfortable to the child as it is to the adult. 

TRUSTING YOUR CHILD 

Often the question arises: "Will they tell to other children 
this newly found knowledge? " If the wise mother makes them 
feel they are a part of a " family," and reminds them that 
such matters as the secrets about Santa Claus, the stork, and 
the baby nest are only discussed in " family groups," they are 
often seized with the normal pride which accompanies confi- 
dence, and often keep secrets as well or even better than do 
most adults. 

One day a little man, three-and-a-half years old, was posing 
for a photograph. The photographer said : " My little fellow, 
you pose well. We've had such a good time together. Where 
did they get such a lad as you ? " 

The mother's heart stood still. From her hiding place behind 
a large curtain at the back of the studio, she listened, wonder- 
ing what would be his answer. 

At first he hesitated, but after a moment's pause, said: 
" Really, Mr. W. if you don't know I feel sorry for you, and 
I'd really like to tell you, but I can't, it's a secret between me 
and my mamma." 

Children enjoy secrets. If possible, isolate a group of sub- 



TEACHING TRUTH 421 

jects that are not to be discussed with playmates, such as 
Santa Claus facts, the stork story, and the baby story; often 
the very isolation of one single fact stands out so big in the 
child's mind that he is many times tempted to mention it, when, 
if it were associated with a whole group of " family secrets " 
he would seldom be led to talk about it. As we have said, 
children can keep secrets much better than most adults; and 
just suppose they should tell something — what harm? With 
twenty-five false stories in the neighborhood, suppose one story 
of truth should escape ! No particular harm would result ; but 
I find they keep these secrets well. 

Numerous questions will arise which should be met with open 
frankness. No blush, no shame, should even suggest itself, for 
we are dealing with a wonderful truth, so let us give out our 
answers with clean hearts and pure minds. The Great Father 
will bless us and surround our loved " flock " with a garment 
of confidence in mother and father that will protect from 
much of the evil which is in the world, and, eventually, our 
little ones will grow into men and women whose very life of 
purity will cast its influence into the social circle. Only 
the company of the good and the true and the pure will be 
sought when associating with the opposite sex; while, in the 
end, better mothers and better fathers will be developed for 
the work of the next generation. 

TEN POSSIBLE CAUSES OF SECRET VICE 

1. The attention of the little folks is often drawn to the 
sexual organs by a sensation of itching which accompanies a 
state of uncleanliness and filth. The genitals must be kept 
scrupulously clean. Elsewhere in this book we paid our 
respects to the rubber diaper, and we wish to reiterate at this 
time that it is in all probability responsible for a great deal 
of masturbation. The constant moisture and heat keeps the 
genital organs in a state of congestion which is more or less 
accompanied by itching sensations. 

2. A long or tight foreskin in the male child favors the 
accumulation of secretions which not only occasion itching sen- 
sations but oftentimes are the cause of convulsions in early 



422 THE MOTHER AND HER CHILD 

infancy. In the case of the female, a tight foreskin over 
the clitoris will retain secretions which also cause an itching 
sensation. 

3. Unscrupulous nurses sometimes actually teach these little 
fellows to masturbate. 

4. Lying in bed on the back with a full bladder, in the case 
of the boy, often produces an erection of the penis, and this 
is usually accompanied by a feeling of fullness which serves 
to direct the mind to the genital organs. 

5. Lying in bed alone with nothing to do but to investigate 
often results in secret vice. 

6. The unwise practice of allowing children to visit each 
other over night and sleep together, is often productive of 
mischief. 

7. Constantly telling a little girl to keep her feet down, to 
keep her dress down, makes her over conscious of sex and 
otherwise causes the attention to be directed in unhealthy 
channels. 

8. Teasing a child unnecessarily about a little sweetheart 
often produces an emotional reaction which is not altogether 
desirable. These suggestions are especially bad in the older 
children. 

9. Unwise sex knowledge is usually productive of curious 
investigations, which if not properly followed up, particularly 
in those children who are temperamentally secretive, and who 
do not fully confide in mother and father, often results in 
moral misdemeanors. 

10. Do not allow two young children habitually to isolate 
themselves in their play. Direct their play away from the 
attic, the basement, and other places remote from direct obser- 
vation. 

There is no use telling a child not to touch that part of his 
body, particularly if it is a boy, for it is going to be absolutely 
impossible for him to carry out such instructions. One mother 
overheard her caretaker say, " Don't put your hand there, it 
isn't nice." Immediately the wise mother called the caretaker 
to her and reminded her that most children usually continue 
to investigate even though they are told not to, and so the care- 



TEACHING TRUTH 423 

taker received this instruction : " When you see Harry putting 
his hand to that particular part of his body, just gently draw 
it away and divert his attention to something else, and when 
he goes to sleep in his little bed teach him to lie on his side 
and bring his little hands up under his chin or the side of his 
face and remain near him telling him a beautiful story until 
the eyes begin to get sleepy and pick him up immediately on 
awaking in the morning." 

This mother was quite unlike the mother who once came to 
my office, saying : " Doctor Lena, I have done everything to 
prevent my boy's handling himself, why every time he wakes 
up at night I am always awake and I instantly say to him, 
Charlie where are your hands? You see Doctor, I am doing 
the best I know how." Very likely it is unnecessary to call 
the attention of the reader to the fact that this mother was 
doing more harm than good in constantly calling his attention 
to the fact that he did have a sexual side to his nature. 

TRUTH VS. EXAGGERATION 

And just here let us add that while masturbation is an 
unclean habit, an impure habit, and a thing altogether to be 
shunned, we would not be honest to ourselves and to our 
readers if we did not explain that under no circumstances 
does it make foolish minds out of sound minds or insane 
minds out of sane minds. If your boy or your girl is going to 
grow up to be foolish or insane he had a through ticket for 
the feebleminded institution or the insane asylum when he 
was born into the world. The time when masturbation does 
affect the mind of the child is when the mind awakens to the 
fact that it is allowing an abnormal, unclean, or filthy habit 
to dominate mind, soul, and body, and then, and usually not 
until then, does this bad habit begin to cause mental depression 
and a host of other symptoms that so often accompany mas- 
turbation. 

In our worthy efforts to combat the evils of secret vice let 
us not go to the other extreme and create such a condition of 
mind in the youth of our generation as to lay the foun- 
dation for sexual neurasthenia later on in life, as a result of 



424 THE MOTHER AND HER CHILD 

the protracted worry, constant brooding, and conscientious con- 
demnation, which they so often experience following some 
brief or trivial indulgence in early secret vice. Let us fight 
this vice with the truth, and not resort to over-exaggerated 
pictures which can only serve to blight the hopes and destroy 
the courage of over-sensitive boys and girls after they have 
grown up — as they look back on their lives and recall perhaps 
a single misstep in their childhood. In this way we can hope 
to do good today without mortgaging the child's happiness 
and mental peace in years to come. 



APPENDIX 



APPENDIX 



BATHS USED TO REDUCE FEVER 



1. The Sponge Bath. The child, completely undressed but 
loosely wrapped in a wool blanket, is placed on a table so that 
the mother or a nurse may conveniently stand while administering 
the bath. Close at hand have a number of soft linen towels and 
a large bowl of tepid water which may or may not contain a 
small amount of alcohol, witch-hazel, salt, or vinegar, according 
to the doctor's directions. The upper portion of the body is 
partially uncovered and the tepid water is applied with the hands 
to the skin surface of one arm. The hands may be dipped in 
water from one to four times, thus making repeated applica- 
tions of the water to the arm. These are followed by careful 
drying — patting rather than rubbing. The other arm is now 
taken, then the chest, then the back and last the legs. 

2. The Wet-Sheet Pack. Two light-weight wool blankets are 
folded to fit the child; they should extend eighteen inches below 
the feet and should be wide enough to lap well in front. A sheet 
just large enough to envelop the body is then wrung out of 
cold water and spread out over the woolen blankets. The fever- 
ish child is entirely disrobed and is placed on the wet sheet, 
which is quickly wrapped about the body, over the chest, under 
the arms, and between the legs — coming in contact with the 
entire skin surface. The dry blankets are quickly brought 
around and tucked snugly about the patient. This is a cooling 
wet-sheet pack and will often so relieve the nervousness and 
irritability of a feverish child that he will go to sleep in the 
pack. In the very young child, under two years, it is important 
to put some accessory warmth to the feet such as a warm-water 
bottle — not hot. The effect of this pack is very quieting, and 
is indicated when the temperature of the child reaches 103 F. 
or more. 

427 



428 THE MOTHER AND HER CHILD 

3. The Graduated Bath. This is usually administered in a 
large bathtub and is beneficial in the fevers of the older chil- 
dren. The temperature of the water should be one or two 
degrees higher than the body temperature, for example — if 
the child's temperature is 103 F. then the bath starts out with 
a temperature of 104 or 105 F. The temperature is then grad- 
ually lowered, about a degree every two minutes, until it reaches 
92 or 90 F. A helper should support the head while the mother 
or nurse briskly rubs the entire skin surface of the body. This 
friction greatly facilitates the fever-reducing work of the bath 
because it brings the blood to the surface where it is more 
readily cooled by the bath. This bath should last ten or fifteen 
minutes. 

4. The Hot Sponge Bath. Often, in combating the high fever 
of typhoid, the hot sponge bath is valuable. The hands are 
dipped in water just as hot as can be borne and are applied to 
the chilly, mottled skin which is so often seen in high fever. This 
bath is administered just as is the tepid sponge bath. Evapora- 
tion is allowed to take place to some extent by delaying the dry- 
ing. In this instance the child should be wrapped in a warm 
wool blanket with only a portion of the body exposed at one 
time. 

5. The Hot-Blanket Pack. The hot-blanket pack is indicated 
at the onset of many fevers such as in typhoid, grippe, pneu- 
monia, etc. Like the wet-sheet pack, the blankets are spread 
upon the bed, abundant accessory heat is applied- — such as a 
half-dozen hot-water bottles. In the absence of these, glass 
jars or hot ears of corn may be utilized. Hot bricks or hot 
stove lids wrapped in paper are also serviceable. A blanket, in 
size to suit the individual (an adult would use a full single 
blanket, a child one-half of a single blanket), is wrung very 
dry from boiling water. This may be done by the means of a 
wash wringer, or two persons grasping the blanket by its gath- 
ered ends may so twist it that it looks very much like an old- 
fashioned twisted doughnut. The twist is now lowered into 
boiling water, and as each pulls the twist wrings itself. This is 
at once quickly spread out so as to let the child lay on the 
center, and then the hot sides are brought in contact with the 



APPENDIX 429 

skin, just as in the wet-sheet pack. The dry blankets are now 
brought quickly and snugly about the child. Just outside the 
second dry blanket the accessory heat is placed to the sides of 
the trunk, the sides of the thighs, and one at the feet. A 
wrapped stove lid or a hot-water bottle is placed over the 
pelvis and one under the back. Cold cloths are put on the face 
and around the neck, and these should be changed every three 
minutes. This pack continues for fifteen or twenty minutes, at 
the end of which time the accessory heat and the wet blanket 
are removed and the patient is cooled off by a cold mitten fric- 
tion, a saline rub, a witch-hazel rub, or an alcohol rub; or the 
patient may be placed in a tub of water, temperature 98 F., 
after which he should be carefully dried off. 

6. Sweating Baths. Another bath which is effectual at the 
onset of grippe or pneumonia is the sweating bath. The bowels 
should have moved some time before the treatment. Have ready 
a large bowl of ice water, two turkish towels, one sheet, and 
four wool blankets. The bathtub is now filled with water at the 
temperature of 100 F. ; which is quickly raised up to 103 or 
104 F. Ice-water towels are applied to the head, neck and heart. 
The patient remains in this bath for about ten minutes, after 
which he steps out and at once gets into the four hot, dry 
blankets previously spread out on the bed. No time is lost, the 
patient is quickly wrapped in the hot blankets and sweating 
continues for twenty minutes. The covering is now loosened 
and gradual cooling takes place. It is well to go to bed at once. 

TONIC BATHS 

1. The Cold Mitten Friction. The cold mitten friction is a 
bath that is applicable to any condition where the child or adult 
needs " toning up." It should always be preceded by heat to the 
feet. The following articles are necessary. Four or five turkish 
towels, a warm wool blanket, a hot-water bottle for the feet, 
a bowl containing water, a generous piece of ice, and a rough 
mitten without a thumb. The patient's clothes are removed 
and he is wrapped in the warm blanket with heat to the feet. 
One part of the body is taken at a time, first the arm, then the 
other arm, then the chest, the abdomen, one leg, the second 



430 THE MOTHER AND HER CHILD 

leg, and last the back and the buttocks. A dry turkish towel is 
placed under the part to be treated, and after the mittened hand 
is dipped in ice-water, brisk short friction strokes are given to 
the arm until it is pink. Several dippings of the mitten in ice- 
water are necessary. One cannot be too active in administering 
this bath. Slow, Delsarte movements are entirely out of place 
at this time. Action — and quick action — is a necessity. No 
part of the child's body is left until it is pink. It is an invigor- 
ating tonic bath and is indicated in all conditions of low vitality, 
functional inactivity, puniness, rickets, etc. 

2. The Salt Glow. Fill the bathtub half full of warm water, 
temperature ioo F. Slightly moisten one quart of coarse salt. 
Stand the patient in the water, placing one foot on the side 
of the tub while you rub the entire leg with the salt until it is 
very pink. The other leg is treated in the same manner, as also 
are the arms, abdomen, chest, and last, the back. By this time 
he will be all aglow from head to foot. Rinse off the salt, and 
give him a cold dash with the hands or a spray. 

THE NEUTRAL BATH 

Fill the tub with water at just 97 F., and remain in the bath 
for twenty minutes or more, with the eyes covered, all the while 
maintaining the temperature at 97 F. Dry gently with a sheet 
to avoid exertion and exposure. Go at once to bed. 

FOMENTATIONS 

Hot fomentations often relieve suffering and are indicated 
in such conditions as menstrual pain, abdominal cramps, colic, 
backaches, etc. A good substitute for fomentations may be 
given as follows : Fill a hot bag half-full of boiling water. 
Over this place a wet flannel and two layers of dry flannel. 
Apply for fifteen or twenty minutes over the skin area to be 
treated, finishing up with a cold water or alcohol rub. 

A very effectual way of applying moist heat to any portion of 
the body is by the means of hot fomentations which are given 
as follows : 

One-fourth of a single woolen blanket (part cotton) is folded 
and grasped at the ends and twisted like an old-fashioned dough- 



APPENDIX 43i 

nut. The twist is then immersed in boiling water, the hands 
still grasping the dry ends, and then by simply pulling out the 
twist (widely separating the hands) the fomentation wrings 
itself. This is placed steaming hot over the affected area which 
has been first covered by a dry flannel. It is allowed to remain 
on for three or four minutes, and then another hot one wrung 
from the boiling water replaces the cool one. About four or 
five such applications are made. The skin should be very red 
at the close of this treatment. It is finished up with a quick, 
cold application to the reddened skin area. 

THE SOAP SHAMPOO 

The undressed child is placed upon a low stool in the half- 
filled bathtub at 100 F. with the feet in the warm water. A 
good lather is applied all over the body with good friction by 
the means of a shampoo brush and soap. He is then allowed 
to sit down in the tub and splash about all he pleases, rinse the 
soap off and allow him to have a good time generally. At the 
close of the treatment the water is cooled down and the treat- 
ment is finished with a brisk rub with the hands dipped in cold 
water. The skin of the child should be pink at the close of the 
treatment. 

MOIST ABDOMINAL BANDAGE 

The moist abdominal bandage is indicated in such condi- 
tions as kidney inflammation which is so often seen in the second 
week of scarlet fever; or in congestion of any of the internal 
organs such as the liver, the stomach, intestines, etc., and is 
applied as follows : Spread out the flannel bandage and over it 
place the mackintosh. Wring dry the cotton strip from cold 
water, and spread it over the mackintosh. Wrap all three layers, 
the wet cloth next the skin, closely about the body, so as to pre- 
vent the air from getting under it. Be sure that the feet are 
warm while adjusting the bandage. In the morning remove 
the bandage, and rub the skin briskly with a turkish towel 
dipped in cold water, until the skin is pink and dry. The 
cotton strip should be boiled every other day to avoid skin 
eruptions. 



432 THE MOTHER AND HER CHILD 

HEATING COMPRESS 

The heating compress is indicated in the following cases: 
Sprained ankles, rheumatic joints, arthritis, sore throat, etc. 
Directions: Wring two thicknesses of cheesecloth from cold 
water, place over the painful part, and quickly cover with a 
mackintosh and two thicknesses of woolen blanket bandage. 
On removing in the morning, sponge with cold water or 
alcohol. 

MUSTARD PASTE 

In the bronchitis of small children, particularly babies, 
mustard pastes are to be preferred to the hot fomentations 
which are used to such great advantage in children above ten. 
The mustard paste is administered as follows : One part of 
mustard and six parts of flour of the same measurements are 
quickly stirred up with warm water to a paste thin enough 
to spread well upon a piece of thin muslin, which is large 
enough to cover twice the part to be treated. One-half of this 
muslin is thus covered with the mustard and the dry piece of 
cloth brought over. The edges are then folded in such a way 
that the mustard will not run out. This is applied to the affected 
part and allowed to remain for seven minutes on an infant, 
nine minutes on a child, and ten or twelve minutes on an adult. 
It is then removed and the moisture which is always seen 
on the reddened skin surface is not wiped off but talcum powder 
is sprinkled on thickly to absorb it. If this is done, a mustard 
paste may be repeated every two hours if necessary and no 
blistering or other harm will come to the skin. 

THE OIL-SILK JACKET 

The oil-silk jacket is used in bronchitis of babies and chil- 
dren. It consists of three layers, the innermost layer of cheese- 
cloth, the middle layer of thin sheet wadding, and the outer 
layer of oil-silk. This jacket should comfortably cover the 
chest, front, and back; it has no sleeves, and is opened on the 
shoulder and under the arm. It should always follow the 
mustard paste in bronchitis. There should always be two 



APPENDIX 433 

such cheesecloth and cotton jackets with the oil-silk covering 
so they may be changed every twelve hours, thus allowing for 
airing. 

STEAM INHALATIONS 

1. Steam inhalations are indicated in hoarseness and bron- 
chitis. They may be given in a number of ways. Perhaps 
that most convenient for the young infant is the " bronchitis 
tent." A sheet completely covers the crib, and, with the bed 
amply protected with rubber sheeting or an extra blanket, steam 
is allowed to enter under the sheet at the foot of the bed from 
a funnel put into the nose of the teakettle. The steam should 
continue for seven or eight minutes. 

2. A large, heavy-paper funnel is put in the nose of the 
teakettle which is boiling on the gas range. The mother holds 
the child in her arms while she is enveloped with a sheet which 
also includes the funnel. A helper carefully guards the flame. 
The mother and baby may thus conveniently get the steam 
with very little difficulty. 

3. For the older child or adult, steam inhalations are to be 
had from the ordinary croup kettle or from a twelve- or four- 
teen-inch tin can which is filled two-thirds full of boiling 
water. Over the top is loosely spread a cheesecloth upon which 
a few drops of compound tincture of benzoin or eucalyptus are 
sprinkled. The opened mouth is brought near the top of this 
can and a towel is thrown over the head, can and all; the 
patient thus being able satisfactorily to inhale the medicated 
steam. 

LOTIONS FOR SORE MOUTH 

Boric-Acid-and-Myrrh Lotion. 

Boric acid 20 grains 

Tincture of myrrh y 2 fluidrachm 

Glycerine 1 fluidrachm 

Water, enough to make 1 fluid ounce 

Apply frequently to the inside of the mouth for in- 
flammation or thrush. 



434 THE MOTHER AND HER CHILD 

FOR NOSEBLEED 

Tannic acid 2 drachms 

Glycerine 1 fluidrachm 

Water 2 fluid ounces 

To be injected or snuffed into the nose in obstinate 
cases of nosebleed. 

THROAT GARGLES 

Dobell's solution is an excellent throat gargle. A solution of 
half alcohol and half water is also a splendid gargle. 

MOUTH WASH 

Listerine 2 teaspoons 

Soda bicarbonate 10 grains 

Water 4 ounces 

Essence of cinnamon, six drops- in one-half glass cold water, 

may also be used in brushing the teeth and in cleansing the 

tongue and mouth. 

DISINFECTANTS 

1. Carbolic Acid. 

Carbolic acid (95%) 6 ounces 

Glycerine 4 ounces 

Water 1 gallon 

Clothes should be soaked in this for several hours, then 
removed in a covered receptacle and boiled thoroughly. Sheets 
may be wet with this and hung at the doors in case of infec- 
tious diseases. 

2. Chloride of Lime. 

Chloride of Lime 4 ounces 

Water (rain) 1 gallon 

In typhoid fever, all the movements from the bowels should 
be thoroughly mixed with this, covered and allowed to stand 
several hours before pouring down the water closet. All 
vomited matter should be treated the same way. 

POULTICES 

There are a number of mush poultices recommended for 
different conditions — boils, felons, etc., but we find the aseptic 



APPENDIX 435 

heating compress to be as effectual as any of these dirty, 
mush poultices and we suggest that our readers try the boracic- 
acid poultice which is put on as follows: Over any infected 
area or abrasion of the skin a thick padding of cotton moistened 
by a saturated boracic-acid solution is placed. This is entirely 
covered with wax paper or oiled-silk, and held in place by a 
binder. It is sanitary and much to be preferred to any of the 
mush poultices of bygone days. 

COUGH SYRUP 

A very useful cough syrup may be made as follows: Two 
tablespoons of flaxseed are steeped on the stove until clear, 
the jelly strained and flavored quite sour with lemon juice to 
which is added rock candy for sweetening. This will often 
effectively relieve the irritating coughs of childhood. 

LOTIONS FOR CHAPPED HANDS 

No. i. Glycerine 3 ounces 

Tr. Benzoin ]/ 2 ounce 

Water i ounce 

No. 2. Glycerine 2 ounces 

Lemon juice l / 2 ounce 

Tr. Myrrh l / 2 ounce 

No. 3. Glycerine 2 ounces 

Rose Water 2 ounces 

Acetic Acid 2 ounces 

ECZEMA 

We wish to submit two very useful prescriptions for that 
troublesome skin disease which is so annoying in childhood 
as well as in adult life. Prescription No. 1 is a clear fluid, and 
after the affected area is thoroughly cleansed with resinol 
soap and rinsed in soft water, the lotion is applied and allowed 
to dry. No. 2 is then patted on with sterile cotton and often 
repeated to keep the ecezmatous skin area moist. This has 
proved curative in many persistent cases. 



436 THE MOTHER AND HER CHILD 

Lotion No. I. 

Acid Carbolic I drachm 

Listerine I drachm 

Rose Water 3 ounces 

Alcohol q. s 6 ounces 

Apply No. i and allow to dry of itself. 

Lotion No. 2. 

Ichthyol 4 drachms 

Lime Water I ounce 

Oil sweet almonds i ounce 

Glycerine i Yz ounces 

Rose Water i y 2 ounces 

Apply No. 2 and repeat to keep moist. 

CONSTIPATION 

We submit the following home regime, which has . proved 
successful to many sufferers for the treatment of constipa- 
tion. 

i. On rising in the morning, remove the moist abdominal 
bandage (mentioned above) ; drink two-thirds of a glass of 
cold water; and spend fifteen to twenty minutes in the follow- 
ing exercises, before dressing: Abdominal lifting with deep 
breathing, auto-massage, leg raising, trunk twisting, trunk bend- 
ing — forward and to sides ; lying down for the trunk raising, 
and sitting for the trunk circumduction. Immediately follow- 
ing these exercises, go to stool. Have feet raised from the 
floor eight or ten inches, in order to simulate the squatting 
position. 

2. Breakfast should include bran or bran bread, and two or 
three of the following foods : Apples with skins, grapefruit, 
cranberries with skins (but little sugar), and figs. Immediately 
after breakfast walk fifteen minutes in the open air, practicing 
deep abdominal breathing. If the results at stool before break- 
fast were not satisfactory, vaseline rectum and go to stool 
again. 

3. Lunch should consist of fruit only, while dinner should 
include bran bread and two of the following foods: Spinach, 
celery, carrots, parsnips, squash, or cabbage. 



APPENDIX 



437 



4. Before retiring, walk in the open air for fifteen minutes; 
after undressing, exercise same as morning; and on retiring, 
apply the moist abdominal bandage. 



TABLE OF POISONS AND ANTIDOTES 

Poison. Antidotes. 



Unknown 



rEmetic, followed by Jeaunel's antidote 
1 and soothing drinks. 



Acid — acetic, hydrochloric, 
sulphuric, nitric 



'An alkali, such as magnesia, chalk, 
whiting, soda, soap ; followed by 
soothing drinks or sweet oil. 



. ., , .. f Epsom salts in abundance; soap; no 

Acd-carbohc, creosote.. \ ^ Dilute alcohol . 



Acid — oxalic, including 
" salts of lemon " 



Emetic, followed by lime (as chalk, 
plaster, whiting) or magnesia, but 
not by potash or soda ; then soothing 
drinks. 



Acid — prussic 



r Fresh air; ammonia to nostrils 
\ douche; artificial respiration. 



cold 



Aconite 



rEmetic, followed by digitalis; no pil- 
\ low under head ; free stimulation. 



Alcohol (brandy, etc.) 



rEmetic; cold douche on head; warmth 
X and artificial respiration. 



Alkalies — ammonia, spirits 
of hartshorn, lye, caustic 
potash 



Vinegar or lemon juice, followed by 
soothing drinks or sweet oil. 



Antimony (tartar emetic) . - 



Emetic if vomiting is not already pro- 
fuse; then tannic acid freely, or 
strong tea ; later, milk or other 
soothing drinks ; finally, castor oil 
to empty the bowels. 



438 



THE MOTHER AND HER CHILD 



Arsenic (Fowler's solution 
Paris green, "Rough on- 
Rats") 



Emetic, quickly followed by plenty of 
a fresh mixture of the tincture of 
chloride of iron with calcined mag- 
nesia, washing or baking soda, or 
water of ammonia, or by Jeaunel's 
antidote. Then white of egg, sooth- 
ing drinks, or sweet oil; castor oil 
to empty bowels. 



Atropine (see Belladonna) . 



Belladonna (atropine) 



["Emetic; tannic acid freely; cold to 
A head ; coffee. Stimulants and 
I warmth if needed. 



Blue stone; blue vitriol (see 
Copper). 



Chloral 



'Emetic (but often useless) ; external 
heat ; stimulants ; strong coffee ; 
strychnine; atropine; artificial res- 
piration. 



Chloroform, inhaled. 



JCold douche; friction of skin; invert- 
1 ing child ; artificial respiration. 



„ ... L1 fEmetic, followed by white of egg or 

Copper (blue stone ; blue M1 .« . L , * , 

. . , ,. . . A milk, yellow prussiate of potash; 

vitriol ; verdigris) . . . , . , 

I then soothing drinks. 



Corrosive sublimate (bi- 
chlorid of mercury) 



Emetic, followed by white of egg or 
milk; soothing drinks; tannic acid 
freely; castor oil to open bowels. 



Cyanide of potash (see 
Acid, prussic). 

Fowler's solution (see 
Arsenic). 



_..,... , r Inhalation of oxygen; artificial respi- 

Gas (illuminating gas, coal ,. • , -, ,, 

^ J ration; ammonia to nostrils; cold 

gas) 1 douche. 



APPENDIX 



439 



Iodine 



[Starch or flour mixed with water given 
I freely; emetic; soothing drinks. 



Laudanum (see Opium). 



Lead (sugar of lead) 



["Emetic, followed by Epsom salts: 
\ white of egg or milk ; alum. 



Matches (see Phosphorus). 

Morphine (see Opium). 

Nux vomica (see Strych- 
nine). 



Opium 


(including 


lauda- 


num, 


morphine, 


pare- 


gone, 


soothing 


syrups, 


etc.) 







Emetic (but generally useless) ; per- 
manganate of potash in doses of 4 or 
5 grains if case is seen early; strong 
coffee; atropine; keep child awake 
and breathing by cold douche to head 
and spine, walking, etc., but not to 
extent of exhaustion ; artificial res- 
piration. 



Paregoric (see Opium). 
Paris green (see Arsenic). 



Phosphorus (match-heads, 
some roach and rat poi- 
sons) 



Emetic; then permanganate of potash 
in doses of 4 or 5 grains well 
diluted, and frequently repeated ; 
then Epsom salts or magnesia to 
open bowels, but no milk or oil of 
any kind. 



Poisonous plants (Jimson 
weed, poisonous mush- 
rooms, deadly nightshade, 
tobacco, etc.) 

Prussic acid (see Acid, 
prussic). 



'Emetic, followed by tannic acid ; strong 
coffee or brandy ; ammonia to nos- 
trils ; external warmth ; artificial 
respiration. 



440 THE MOTHER AND HER CHILD 

Silver nitrate (lunar caus- rTable-salt, followed by emetic; milk 
tic) \ or white of eggs. 

., j c j rEmetic, followed by castor oil as 

Spoiled food J 

\ purgative. 

Strychnine (nux vomica, ("Emetic, followed by tannic acid, bro- 
some rat poisons) [ mide of potash freely, or chloral. 

Tartar emetic (see Anti- 
mony) . 

TABLE SHOWING THE AVERAGE WEIGHT, HEIGHT, AND CIRCUM- 
FERENCE OF HEAD AND CHEST OF BOYS * 

At birth. 

Weight 7 z /2 pounds 

Height 20^4 inches 

Chest 13^2 inches 

Head 14 inches 

One year. 

Weight 21 pounds 

Height 29 inches 

Chest 18 inches 

Head 18 inches 

Two years. 

Weight 27 pounds 

Height 32 inches 

Chest 19 inches 

Head 19 inches 

Three years. 

Weight 32 pounds 

Height 35 inches 

Chest 20 inches 

Head 19^4 inches 

Four years. 

Weight 36 pounds 

Height 38 inches 

Chest 20% inches 

Head 19^ inches 

* Weights for the first four years are without clothes, after that with ordi- 
nary house clothes. 

The weight of girls is on the average about one pound less than boys. They 
are about the same in height. 



APPENDIX 441 

Five years. 

Weight 41 pounds 

Height 41^ inches 

Chest 21 y 2 inches 

Head 20^ inches 

Six years. 

Weight 45 pounds 

Height 44 inches 

Chest 23 inches 

Seven years. 

Weight 49^2 pounds 

Height 46 inches 

Chest 22^/2 inches 

Eight years. 

Weight 54^ pounds 

Height 48 inches 

Chest 24^2 inches 

Nine years. 

Weight 60 pounds 

Height 50 inches 

Chest 25 inches 

Ten years. 

Weight 66^4 pounds 

Height 52 inches 

Chest 26 inches 

ICHTHYOL SUPPOSITORIES 

Ichthyol 5 per cent 

Cocoa Butter q. s. ad. to make 24 suppositories. 

Sig. Use one suppository in the rectum each evening 
for hemorrhoids. 

OIL ENEMA 

The best way to administer an oil enema is by means of a 
special enema can which holds one pint, to which is attached 
a rubber tube. It is wise not to use an ordinary fountain 
syringe as the oil spoils the rubber very quickly. This oil is 
allowed to flow in slowly, tinder low pressure, and should be 
retained over night. Any oil is acceptable, the cheaper sweet 
oils will serve just as well as olive oil. 



442 



THE MOTHER AND HER CHILD 





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APPENDIX 443 

HOT COLONIC FLUSHING 

The hot colonic flushing is particularly serviceable in com- 
bating the sick headaches of migraine. They should be taken at 
night just before retiring with the temperature of water as hot 
as can be borne, from 108 to no F. Half of the water is 
allowed to flow into the colon and is retained as long as possible. 
This brings the heat in close contact with the sympathetic nerv- 
ous system whose headquarters is in the abdomen. 

ENEMAS 

Position for an Enema. Lie on left side, knees brought up 
against abdomen, with the left arm well underneath. This 
will relax the abdominal muscles and allow the water to pass 
upward more freely. The water should be allowed to flow until 
it is felt low on the right side. 

The one, two, three enema is an injection that is used for the 
relief of gas in the bowel. It consists of the following: One 
part epsom salts, two parts glycerine, and three parts soap suds. 
It is introduced by the aid of the colon tube and retained as 
long as is possible. 

Glycerine and soapy water, equal parts, may be introduced 
into the bowel for temporary relief of a persistent constipation. 

In instances when feeding by the mouth is impossible, nutrient 
enemas should be given every three or four hours during the 
day. The absorption does not take place in the large bowel as 
readily as in the small intestines, so only a small amount of a 
more highly concentrated solution is given at one time. A 
child one year of age will be given one teaspoon, from one to 
four years of age a teaspoon to a tablespoon is allowed, and 
up to twelve years from one to eight tablespoons are given in 
the nutrient enema. Peptonized meat preparations may be 
employed in greater concentration than directed by the use of 
the mouth. Peptonized milk containing an egg is often used. 
The pepsin is added to the mixture only when warm, and is 
injected at once. 

EMETICS 

i. A glass of warm water containing as much common table 
salt as can be dissolved. 



444 THE MOTHER AND HER CHILD 

2. A teaspoon of mustard in a large glass of warm water. 

3. A teaspoon of syrup of ipecac, repeated in fifteen minutes 
if necessary. 

Any one of these emetics is useful in instances where it is 
desirable to empty the stomach at once. 

A CALORIE 

A calorie is the heat unit used in the estimation of the fuel 
value of various foods. For instance, an ordinary slice of 
homemade bread contains 100 calories. An ordinary fig con- 
tains almost 100 calories. A large orange or an apple or a 
glass of grape juice contains about 100 calories. There are 
100 calories in three teaspoons of sugar or honey. 

A complete food list with the estimation of calorie value of 
foods is found in The Science of Living, page 370, while on 
page 99 of the same book is a very helpful table showing the 
amounts of various foods required to equal 100 calories. The 
reader will find this exceedingly practical in estimating food 
values for the household. 

ACIDIFYING AND ALKALINIZING FOODS 

Since we find that in all acute diseases the acidity of the 
urine is greatly increased and in time of health it is less acid, 
we submit two lists of foods which tend to acidify the urine or 
to alkalinize the urine. 

FOODS WHICH TEND TO FOODS WHICH TEND TO 

ACIDIFY. ALKALINIZE. 

1. Animal Foods: All forms I. Dairy Products: Milk, ice 
of flesh foods, fish, fowl, etc., cream, cottage cheese, cheese, 
including all kinds of meat buttermilk, etc. 

broths, soups, beef tea, bouillon, 2. Potatoes and bananas. 

etc. 3. Soups: All forms of vege- 

2. Eggs. table and fruit soups and broths. 

3. Breadstuff s: All kinds of 4. Fruit Juices: All the fresh 
breads, whether made of wheat, fruit juices except plums. 

rye or corn, crackers, toasts, 5. Fresh Fruits: All fresh 

griddle cakes, etc. fruits, sweet and sour, except 

4. Pastries: All sorts of pies plums and cranberries. 



APPENDIX 445 

and cakes — except fruit pies, 6. Vegetables: All kinds, espe- 
and other desserts containing cially beets, carrots, celery, let- 
milk or sour fruits. tuce, and muskmelon. 

5. Cereals: Rice, oatmeal, and 7. Dried Fruits: Figs, raisins, 
breakfast foods of all kinds, in- dates, currants — all except 
eluding the flaked and toasted prunes. 

breakfast foods. 8. The Legumes: Beans, peas, 

6. Peanuts, plums, prunes, and and lentils. 

cranberries. Plums and cran- 9. The Nuts: All the nuts 

berries fall in this column be- belong in this column, including 
cause of their benzoic acid, almonds and chestnuts, 
which the body cannot fully 
oxidize. 

CEREAL WATERS, ETC. 

It is often necessary to give the infant or the young child 
cereal water to replace food in occasions of summer diarrhoea, 
etc. 

1. Barley Water. 

One tablespoon of barley flour in one pint of water. Boil for 
one-half hour, strain, and add sufficient boiled water to make 
one pint. 

2. Flaxseed Tea. 

One tablespoon of flaxseed, one pint of boiling water; let 
stand and keep warm for one hour; strain. Add juice of 
lemon. 

3. Oatmeal Jelly. 

Four tablespoons of oatmeal, one pint of water; boil for 
three hours in double boiler, adding water from time to time; 
strain. 

4. Toast Water. 

One, two, or three slices of bread toasted dark brown, but 
not burned. Put in one quart of boiling water, cover, and 
strain when cold. 

5. Arrowroot Water. 

Wet two teaspoons of arrowroot with a little cold water, and 
rub until smooth; then stir into one pint of boiling water and 
boil for five minutes, stirring all the while. 

6. Oatmeal Water. 



446 THE MOTHER AND HER CHILD 

One tablespoon of oatmeal to one pint of boiling water, cover 
and let simmer for one hour. Add water from time to time 
as it evaporates; strain. 

y. Rice Water. 

One tablespoon of (washed) rice to one pint of water. Boil 
three hours adding water from time to time. 

FRUIT JUICES 

Fruit juices are exceedingly beneficial all through life; par- 
ticularly is this true during early childhood when the little ones 
are so likely to be constipated. Any of the fruit juices are good, 
particularly the juices from oranges, raisins, prunes, apples, 
pears, and cranberries. All these juices are better cooked than 
raw with the exception of orange juice. All children should 
have some fruit juice every day. For the very young baby 
the juices are strained through a wire strainer and a clean 
cheesecloth so as to remove every particle of solid matter, and 
there should be added an equal amount of cold, boiled water 
for the infant under ten months. 

LEMONADE AND EGGN0GS 

Lemonade, along with orangeade, grapefruitade and limeade 
should be used for children above a year. They should be 
well diluted and not too sweet. 

Eggnogs are splendid for children who need to be helped 
along with their diet. They may be given at the close of the 
meal, never between meals — unless so prescribed by a physician. 
The stomach should have ample time to complete the work of 
digesting one meal before another partial meal is allowed to 
enter it. Eggnogs consist of a well-beaten egg into which 
there is placed a small amount of sugar, flavoring with either 
nutmeg, vanilla, or cinnamon, and the glass filled up with rich 
milk. 

MILKSHAKE 

Milkshake is a delightful drink. The white of an egg with 
one or two teaspoons of sugar, two tablespoons of chopped ice, 



APPENDIX 447 

flavoring, and one ounce of cream are briskly shaken in a milk- 
shaker for two minutes. Cold milk is added to fill the glass. 

MEAT AND MEAT JUICES 

Beef extracts are regarded by the medical profession as 
purely stimulants. Beef juice is practically without food value. 
In the preparation of beef juice the extractives and juices leave 
the fibre. The food is in the fibre of the meat. The extractives 
are purely of a stimulating order. We do not advocate the 
giving of beef tea and beef juices to children; as a rule, we 
think that cereal, gruels, strained soups, and milk are preferable. 

The only reason for cooking meats is to destroy the parasites 
such as tapeworm, trichina, etc., which are so often found in 
the meat. The cooking of meat decreases its digestibility, as 
raw meat is more easily digested than cooked meat, but we feel 
it is necessary to advocate the cooking of meat in order to 
kill the parasites. 

CODDLED EGG 

A fresh egg, shell on, is placed in boiling water which is 
immediately after removed from the fire. The egg then 
cooks slowly in the water, which gradually cools, for seven or 
eight minutes, when the white should be about the consistency 
of jelly. For a delicate digestion the white only should be 
given, with salt; it can be easily separated from the yolk. 
The above is the best form of egg for the young child. Later 
on the eggs may be soft boiled or poached, or even soft 
scrambled. 

SOUPS 

Two varieties of soups are given children. In the early 
months of childhood, from six years to eighteen months, the 
soups are usually strained, but after eighteen months, soups 
may be thickened with flour and rich milk making a cream 
soup of it. Most vegetables make good soups. The pulp from 
such vegetables as asparagus, carrots, beans, peas, tomatoes, 
and potatoes are made into cream soups by the addition of a 
little flour, rich milk, butter, and a dash of salt. 



448 THE MOTHER AND HER CHILD 

BREADS 

New breads should never be given to a child. Only bread 
twenty-four hours old should ever be given to a child under 
six years; it should be cut into slices and allowed to dry out; 
and even then is better if slightly toasted. We publish a 
recipe for bran bread and bran biscuits which are exceedingly 
good for children and adults. 

Recipe for Bran Bread. Two eggs, beaten separately ; three- 
fourths of a cup of molasses, with one round teaspoon soda; 
one cup of sour cream; one cup of sultana seedless raisins; 
one cup of wheat flour, with one heaping teaspoon baking 
powder; two cups of bran; stir well and bake one hour. 

Bran Biscuits. Mix one pint of bran, one-half pint of 
flour, and one level teaspoon of baking soda. Mix one-half 
pint of milk and four tablespoons of molasses. Add this to the 
bran mixture and bake in gem pans. 



INDEX 



INDEX 



Abortion, advice on occurrence of, 
39 ; care needed at third month 
of pregnancy, 38 ; consequences 
of, 7, 8 ; defined, 39 ; remedy for 
threatened, 38 ; warning signs 
of, 38. See also Miscarriage ; 
Pregnancy 

Adenitis, 345 

Adenoids, 303 

Air, supply of fresh, for baby, 
213-17, 219 

Baby, care of the : Abdomen, 
shape of, at birth, 105 ; advice 
in care of baby, 377-78 ; bathing, 
107-8, 111-12, 190-201; bed for, 
arrangement of,i 108, 115 ; bounc- 
ing harmful, 226 ; bowels and 
bladder, training of, 242 ; breast 
of baby, care of, 229 ; buttocks, 
care of, 200 ; chafing, how pre- 
vented, 201, 333 ; chest, shape of, 
105 ; circumcision, when desir- 
. able, 110; clothing of the, 108; 
constipation, 279 ; cord, dressing 
of, 107; diet after first year, 
245-47; ears, treatment of, 198- 
99 ; exercise of baby, 223 ; eyes, 
treatment of, 107, 198-99; falls, 
to be prevented, 228 ; feeding 
the, 109 ; genitals of the, how 
cared for, 110, 200; habits to 
be guarded against, 378; hair, 
treatment of, 201, 233 ; handling, 
111; head, treatment of, 104, 
233, 344; legs of, at birth, 105; 
lifting the baby, how accom- 
plished, 228 ; mouth, treatment 
of, 199 ; necessities for new- 
born baby, 60-61, 64; nose, 
treatment of, 198-99 ; pulse and 
respiration, 105 ; putting to 
sleep, 127, 217; registration of 
birth of, 113; respiration, how 



started at birth, 105-6 ; second 
summer, care during, 230 ; skin 
of baby, 106 ; stools, regulation 
of, 142 ; temperature of baby, 
226 ; the " spoiled "baby, 128 ; 
things bad for babies, list of, 
377 ; treatment of baby during 
and after birth, 67, 69 ; umbili- 
cus, how cared for, 112; urine 
of baby, 109, 223 ; warmth neces- 
sary, 225 ; water, how and when 
administered, 140 ; 222 ; weight 
of baby at birth, 106; when to 
give first feeding, 70. See also 
Colic ; Crying ; Nursery ; Nurs- 
ing the baby ; Sleep ; Urine ; see 
also under several diseases 

Babyhood, 1 

Backache, cause of, 43 ; method of 
relief for, 43-44 

Bathing the baby, toilet, etc., 190- 
201. See also Baby, care of the 

Bed for baby. See Baby, care of 

the; Sleep 
Bed-wetting, 328. See also Urine 

Birthmarks, discusson of, 16, 17, 
18, 40, 338 

Bites, of dogs, snakes, cats, etc., 
349 

Blindness, precautions to avoid, 
in new-born infant, 69, 331. See 
also Baby, care of the 

Blisters (fever), 338 

Blood-pressure, 46 ; observation 
of, 3 

Boils, 337 

Bottle 'feeding, additional foods, 
153 ; bottle, preparation of. 149 ; 
ice-box, home-made, 14S; in- 
tervals between meals, 153; 
nipple, how withdrawn, 152; 



451 



452 



INDEX 



position of baby during feeding, 
150-51; quantity of food, 148; 
refrigeration a necessity, 148 ; 
rules for, 154; schedule for, 
147; stomach, capacity of, 148; 
time allowance for, 152; travel- 
ing, food for baby while, 153 ; 
treatment of baby after, 152 ; 
water, when and how admin- 
istered, 147 . 
Bowel, prolapse of the, 283 
Bow legs, how avoided, 228 
Bran bread, recipes for, 448 
Bravery, how to instil in a child, 

382-84 
Breasts, caked (mastitis), care of, 
100, 136 ff . ; changes in, a sign 
of pregnancy, 4; care of, during 
pregnancy, 33. See also Preg- 
nancy 
Bronchitis, 304 
Bruises, 354 
Burns, 358 

Calisthenics, how applied, 244 

Caretaker (for children), 376-77 

Carriages and go-carts, 227 

Chafing, 333. See also Baby, care 
of the 

Chicken-pox, 294-95 

Chilblains, 356 

Child culture, 1 

Cleft palate, 341 

Clothing the baby, bands, 204; 
booties, 206; caps, 210; diapers, 
204; errors in clothing, 208; 
layette, the, 203-208; night- 
gowns, wrappers, and slips, 207 ; 
rules for, 212 ; shirts, 204 ; shoes, 
210; short clothes, 209; skirts 
and petticoats, 206 ; sleeping-bag, 
207 ; stockings, 206 ; suggestions 
for, 202; suits for play, 210; 
winter garments, 211; wraps, 
210 

Clubfoot, 342 

Colds, 300, 301 

Colic, causes and treatment of, 
129-32, 142, 274 

Confinement, bed and accessories, 
61-62, 64; calculation of date 
of, 5, 6 ; preparations for, 53 ff., 
57 ; supplies needed for, 58 ff. ; 
room for, 61. See also Labor 



Constipation, treatment of, 31, 40; 
in baby, 184, 185, 279 

Contagious diseases, how con- 
tracted, 285 ; incubation period 
of various, 287 ; spread of, 286. 
See also under various diseases 

Convulsions, 326 

Coughing, 255 

Cramps, 41 

Croup, 306 

Crying, abnormal, 124; birth cry, 
123; cause of, 132; colicky cry, 
129; fretful cry, 125; habit 
cry, 127 ; healthy crying, 123 ; 
hunger cry, 124 ; illness cause 
of, when, 129; pain cry, 126; 
" spoiled-baby " crying, 128; 
temper cry, 128 ; thirst cry, 124 

Cuts, wounds, etc., 353 

Deaf-mutism, 331 

Deafness, 302 

Deformities, causes of, 17 

Delivery, calculation of date of, 
5, 6 

Depressors, function of, 9, 15 

Determiners, function of, 9, 15 

Development of child, 240-41 

Diarrhoea, 185, 280 

Diet : Appetite, improvement of 
the, 401 ; assimilation, 360 ; baby, 
diet of, 245-47 ; cellulose, 365 ; 
eating between meals, 368 ; elim- 
ination, 360-62 ; fats, 364 ; food 
requirement (daily), 369; foods, 
full value of, 366; for children, 
367 ; fruit sugars, 363 ; hygiene, 
400; mineral salts, 364; nutri- 
tion, 362 ; proteins, 363 ; starch- 
es, 363 ; treatment of child, daily 
program for, 402-4 ; water, 365. 
See also Feeding the baby ; 
Nursing the baby 

Digestion : Disorder of, chronic 
indigestion, 275 ; stomach, dis- 
ordered, 278 ; stomatitis or 
thrush, 279 ; vomiting, 274. See 
also under various diseases 

Diphtheria, 296 

Discipline, methods of, 316-22 

Dislocations and fractures, 254 

Doctor, choice of, 55 



INDEX 



453 



Earache, 351 

Ears, running, 299 

Eclampsia, 47, 48; prevention of, 
50. See also Urine 

Eczema, 334-35 

Embryonic development, 11, 12 

Enema, how administered, 280 

Exercise, necessity of, during preg- 
nancy, 27 

Exercise of baby, 223 

Eye infections, 298 

Eyes, ears, and nose, care of, 198 ; 
foreign bodies in, 351 

Fainting, 359 

Fear, overcoming of, in children, 
380-82 

Feeble-mindedness, 331 

Feeding the baby : Bottle-fed baby, 
healthy characteristics of, 178 ; 
changes in food to be gradual, 
179 ; constipation, how treated, 
185, 279 ; diarrhoea, cause of, 
185, 280 ; dissatisfaction, signs 
of, 181 ; flatulence, 182; formula, 
choice of, for, 178; infant foods, 
187-89 ; mistakes in formulas, 
180; mixed feeding, 186; over- 
feeding, 183; vomiting, 182; 
weight of baby, 183. See also 
Diet ; Milk ; Nursing the baby 

Fertilization, process of, 8, 9 

Fever, 264. See also Sickness of 
child 

Flatulence. See Feeding the baby 

" Flour ball," how prepared, 175 

Foods, for baby, 153, 165-76; full 
value of, 366. See also Bottle 
feeding ; Infant foods ; Milk 

Freckles, 336 

Frostbites, 356 

Games for children, 392 
Germ plasm, 8 
Glands, enlarged, 345 
Goitre, 42 

Governesses, 370-75 
Grippe, 302 

Habits, inculcation of good, 380-89 
Harelip, 341 



Headache, in children, 326 ; relief 
for, during pregnancy, 45 ; sign 
of auto-intoxication during preg- 
nancy, 47 

Heartburn, care for, 36 

Hemorrhoids, treatment of, 41 

Heredity, effect of, on individual, 
9, 14; extent of influence of, 14, 
15, 19, 20 

Hip-joint disease, 343 

Hives, 336 

Homemaking, 370-75 

Hookworm, 278 

Hospital, recommended for con- 
finement, 55-56 ; requisites for, 
60 

Housekeeping, 370-75 

Hygiene, of baby, 222-31 ; of child, 
400-4. See also Diet 

Hysteria, prevention of, 315 

Indigestion, 275 

Infant foods, 187-89. See also 
Feeding the baby ; Nursing the 
baby 

Infant welfare, 178 

Insects, bites of, 348 

Insomnia, relief for, 45 ; in chil- 
dren, 323 

Itch, the, 339-40 

Jaundice, 276 

Kissing the baby, precautions 
against, 224 

Labor, analgesia in, 86 ; anesthesia 
in, 84-92 ; bath, preliminary, 64 ; 
care of mother during and after, 
67-68 ; chloroform and ether, 
administration of, 91 ; duration 
of, 65 ; duties of nurse before and 
during, 67 ; " false pains " in, 66 ; 
fear in, importance of allaying, 
84; laughing gas (nitrous oxid), 
administration of, 85 ; effect of, 
87 ; pain of, 71, 84-85 ; prepara- 
tions for, 64-65, 67, 72-73; 
progress of, 65 ; second stage of, 
66 ; "sunrise slumber" in, 84-90 ; 
symptoms of approaching, 64 ; 
third stage of, 66 ; " twilight 
sleep" in, 71-72, 73-83; what to 
do in, before arrival of doctor, 
67 



454 



INDEX 



Layette. See Clothing of baby 

Leucorrhea, relief for, 37-38 

Lice, 339 

Lime water, use of, in baby's food, 
173 

Lochia, the, 97 

Lying-in period, the, 93 ; abdominal 
binder, 97 ; " after-pains," 95 : 
bowels, care of, 98 ; breast 
binder, 97 ; " cold-mitten fric- 
tion " during, 95 ; cystitis, how 
avoided, 100 ; diet, rules for the, 
98 ; getting up from bed, when 
to be permitted, 99 ; hemorrhage, 
treatment of, 100 ; infection 
advice for treatment of, 100 
lochia, the, 97 ; nipples, care of 
98 ; nurse, duties of, during, 93 
pneumonia, how avoided, 100 
rest and exercise during, 94 
temperature of mother, 96 ; toilet 
of the vulva, 96 

Malaria, 346 

Maternal instinct, the, 1 

Maternal impressions, explained 

and discussed, 16 
Measles, 293-94 
Medical supervision in early days 

of pregnancy, 2 
Medicine chest, the, 270 
Meningitis, 329 

Menstruation, cessation of, a sign 
of pregnancy, 4 ; cessation of, 
due to other causes than preg- 
nancy, 4 ; passage of ovum at 
time of, 9. See also Pregnancy 

Milk, acidity, how counteracted, 
158; analysis of cow's, 156; 
analysis of mother's, 156; annat- 
to, test for, 159; boiling, when 
necessary, 161 ; bottled milk, 
care of, 163 ; bottles, care of, 
166 ; buttermilk, when used, 174 ; 
certified milk, 161 ; condensed 
milk, how used, 175 ; cow's 
milk, modification of, 157 ; cream 
gauge, 158; cream, gravity of, 
172; dairy, essentials of a good, 
159; "flour ball," the, 175; 
food, special, 175 ; formulas for 
feeding, 171. 173 ; goat's milk, 
use of, 157; herd milk desirable, 
159 ; lactometer, 158 ; lime water, 
use of, 173; "modification" of 
cow's milk, 165 ; nipples, care of, 



166; pasteurization of, 162; pep- 
tonized, 174 ; preparation of, 168- 
70; schedule for feeding, 171; 
seven per cent milk, 173 ; spores, 
how guarded against, 163 ; 
sterilization of, 162; sugar, use 
of, with, 157; "top-milk" for- 
mula, 172; whey, how used, 176. 
See also Feeding the baby 

Milk crust, 198 

Miscarriage, care needed at 
seventh month of pregnancy, 39 ; 
causes of, 39 ; defined, 390. See 
also Abortion ; Pregnancy 

Monstrosities, causes of, 17 

Moral training of child, 415-24 

Morning sickness, a sign of preg- 
nancy, 4; remedies for, 35 ff. ; 
vomiting (pernicious), 44. See 
also Pregnancy 

Mothercraft, 1 ; science of, 2, 370- 
75 

Motherhood, characterized, 1 ; 
preparation for, 2 

Mouth of baby, care of, 199 

Mouth wash for use during preg- 
nancy, 30 

" Mulberry Mass," the, 11 

Mumps, 291 

Nails, ingrowing, 342 

Nature, lessons from, in teaching 

children, 405-12 
Navel, bleeding from the, 284 
Nervousness, hereditary (in child), 

308-10; how overcome, 310-14, 

323-32 

Nervous system, absence of con- 
nection between, of mother and 
child, 18 

Nitrous oxid, effects of, 87-90 

Nosebleed, 352 

Nurse, choice of, 56-57 

Nursery, bath equipment, 121 ; bed, 
arrangement of, 108, 115, 119; 
cleanliness, necessity for, 122; 
equipment of, 114; heating and 
ventilation, 118; lighting, 120; 
refrigerator, 268 ; sleeping blank- 
et, 118; ventilation of, 120 

Nursing the baby, caked breasts, 
136-37 ; diet of mother, 135 ; 
foods to be avoided by mother, 
136; hygiene of nursing mother, 



INDEX 



455 



134; importance of, 133; irrita- 
bility of mother, effect of, 142 ; 
mastitis (caked breast), treat- 
ment for, 100 ; milk supply, how 
increased, 143 ; mixed feeding, 
186 ; mother's milk, constituents 
of, 139 ; overheating of mother 
to be guarded against, 142 ; 
position of mother when, 141 ; 
regularity in feeding, 141 ; sore 
nipples, how treated, 138; stools, 
regulation of, 142; successful or 
unsuccessful, how determined, 
142-43 ; time of first feeding, 
139; to be avoided, when, 144; 
water, administering, 140; wet 
nurse, the, 145. See also Bottle 
feeding; Diet 

Ovary, the, 8 

Ovum, development of, into foetus, 
11, 12 

Paralysis, infantile, 330 

Parents, relation of to children, 
413-24 

Pernicious vomiting. See Morn- 
ing sickness 

Physician, selection of, for treat- 
ment during pregnancy, 21-22 

Pigeon toe, 342 

Placenta, role of, 18 

Play and recreation, 390-91 

Playmates of children, 311 

Pneumonia, 307 

Poisons and antidotes, 356-58 

Pott's disease, 343 

Pregnancy : Bathing, necessity of, 
during, 29 ; blood-pressure in, 
49, 50, 52; breasts, care of the, 
33 ; cheerful anticipation, ad- 
vantages of, 4 ; clothing appro- 
priate during, 22 ; constipation, 
how avoided during, 31-33, 40; 
convulsions, treatment for, 48 ; 
craving for special food, in, 40 ; 
diet during, 24 ff. ; dizziness dur- 
ing, 47; duration of, 5, 12; 
exercise, necessity of, 27 ; fresh 
air, necessity of, 29 ; goitre in, 
42 ; hemorrhoids, treatment of, 
41 ; hygiene of, 21 ff. ; irritation 
of the bladder, 37; kidney com- 
plications, 3 ; medical supervi- 
sion in early days of, 2 ; mental 
state during, how regulated, 



33 ; miscarriage, danger of, at 
seventh month, 39 ; morning 
sickness, remedies for, 35 ; prog- 
ress of, 11, 12; quickening, 5; 
resentfulness of mother, conse- 
quences of, 3 ; rest, necessity 
of, 28 ; signs of, 4 ; swellings 
in, 42, 47 ; teeth, care of, during, 
30 ; urine, diminution of, 47 ; 
urine, testing of. 30 ; vision, 
blurring of, the, 47 ; water, 
necessity of, in, 26. See also 
Abortion ; Miscarriage 
Puerperium. See Lying-in period 

" Quickening," 5. See also Preg- 
nancy 

Rheumatism, 344 
Rickets, 345 
Ringworm, 337 
Rupture, 283 

Saint Vitus' Dance, 330 

Saliva, flow of, not indicative of 
teeth-cutting, when, 233 

Scalds, 358 

Scarlet fever, 292-93 

Scurvy, 344 

Senses of new born baby, 232, 233 

Shortening clothes of baby. See 
Clothing the baby 

Sickness of the child : Abdomen in 
sickness, 254 ; breathing, 256 
chest in sickness, 254; convales 
cence, 272-73 ; cough, the, 255 
cry of infant in sickness, 255 
disinfectants for sick room, 269 
examination of sick child, 260 
facial expression, 254 ; feeding 
directions, _ 259 ; fever, 264 ; 
gestures indicating sickness 
253 ; head indicates sickness 
254 ; medicine chest, the, 270 
medicines, 263 ; mouth, the, 257 
nurse, the, 251 ; nursing records 
262; patent medicines, 271 
position of, in sickness, 252 
pulse, the, 257 ; sick room, loca 
tion of, etc., 266; skin color, 
253 ; stools, the, 258 ; swallow- 
ing, 258 ; temperature and pulse 
263 ; temperature, the, 257 
treatment of sick child, 261 
urine, the, 258. See also under 
several diseases 



456 



INDEX 



Skin troubles, 333 

Sleep: Air, supply of fresh, 213- 
17, 219; bed-clothes, 219; bed- 
time for baby, 218; daily naps, 
221 ; food, effect of, on, 220 ; 
position of baby in, 218; putting 
baby to, 127, 217 ; requirements 
of, by baby, 217; soothing 
syrups, 220 ; waking up in night, 
219 

Smallpox, 295 

Soothing syrups, 220 

Sore throat, 302 

Spasms, 326 

Speech of baby, 243 

Sperm, blending of, with ovum, 11 

Spinal curvature, 342-44 

Spoiling the child, 310 

Sprains, 355 

Stools of baby, 184, 185 

Stream of life, the, 8 

Sucking habits in baby, to be 
guarded against, 224, 378 

Suggestion, effect of, 19, 380-89 

Summer complaint, 278. See also 
Diarrhoea ; Dysentery 

Sunrise slumber. See Labor 

Suppressors, function of, 9, 15 

Swallowing of bones, buttons, etc., 
350 

Syphilis, 346, 347 

Teeth, care of, during pregnancy, 

30 
Teething, 234-37; suggestions for 

treatment during, 237 
Thrush, 279 
Tonsils, diseased, 303 ; tonsilitis, 

302 
Toys, selection of, 230 
Tuberculosis, 346 
Twilight sleep. See Labor 



Twitchings, 327. See also Nerv- 
ousness, hereditary 
Typhoid fever, 288-91 

Umbilical cord, function of, 18 
Uremic poisoning. See Urine 
Urine: Albumin and casts in, 47, 
50 ; bed-wetting, 328 ; diminution 
of, during pregnancy, 47 ; dis- 
turbance in, a sign of pregnancy, 
4, 5 ; eclampsia, 3 ; examination 
of, 3 ; irritation of the bladder, 
37; retention of, by child, 328; 
testing of, during pregnancy, 30, 
42, 45, 49, 55 ; toxemia, indica- 
tions of, 48 ; uremic poisoning, 
3 ; urinating after labor, 97 ; 
urination of baby, 223 ; urine an 
index of disease or sickness, 
258. See also Pregnancy; Sick- 
ness of child 
Uterus, entrance of fertilized 
ovum into, 9, 10 

Vaccination, 295 
Varicose veins, 41 
Vice, secret, causes of, 421 
Vomiting, 274. See also Diges- 
tion, disorders of; Feeding the 
baby 
Vulva, toilet of the, 96 
Vulvovaginitis, 334 

Walking of baby, 244 

Warts, 338 

Water : Administered to baby, 
when, 222 ; necessity of, during 
pregnancy, 26, 45, 48, 50; part 
played by in nutrition of body, 
365 

Water on brain, 331 

Weaning : Breast-fed babies, 241 ; 
bottle-fed babies, 241 

Weight of baby, 183, 238-39 

Whooping cough, 297 

Worms, 276 

































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